Preoperative Prognostic Score (PPS) of Miura et al for a Patient with Locally Advanced Pancreatic Body Cancer After Distal Pancreatectomy and Celiac Axis Resection (DP-CAR)

 

Patient selection: locally advanced pancreatic cancer in body with distal pancreatectomy and en bloc celiac axis resection (DP-CAR) with splenetomy. Locally advanced pancreatic cancer may involve or touch the common hepatic artery and/or celiac axis with perineural invasion.

 

Outcome: median survival in months

 

Parameters from preoperative assessment:

(1) serum C-reactive protein (CRP) in mg/dL

(2) platelet count per µL

(3) serum CA19-9 in U/mL (analytical method and upper limit of normal reference range not given)

Parameter	Findings	Points
serum CRP	< 0.4 mg/dL	0
	>= 0.4 mg/dL	1
platelet count	>= 150,000 per µL	0
	< 150,000 per µL	1
serum CA19-9	< 300 U/mL	0
	>= 300 U/mL	1

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score the worse the median survival time.

 

Score	Median Survival
0	50.6 months
1	22.3 months
2 or 3	7.7 months

 

Intraoperative blood loss >= 940 mL was associated with worse survival.