medical decision support medical decision support
Sign In

Prognostic Index of Ikeda et al for Patients with Locally Advanced, Nonresectable Pancreatic Carcinoma

Purpose: To evaluate a patient with locally advanced, unresectable pancreatic cancer using the prognostic index of Ikeda et al.

Description

Pancreatic cancer that is locally advanced and nonresectable is often treated with a combination of chemotherapy and radiation therapy (chemoradiotherapy, or CRT). Multivariate analysis identified 3 factors that can be used to separate patients into 3 prognostic groups. The authors are from the National Cancer Center Hospital in Tokyo.


Independent prognostic factors identified by multivariate analysis:

(1) ECOG Performance Status

(2) regional lymph nodes

(3) serum CA 19-9

 

Parameter

Finding

Points

ECOG performance status

0 (no symptoms)

0

 

1 (symptomatic but ambulatory)

0

 

2 (bedridden < 50% of day)

1

 

3 (bedridden >= 50% of day)

NA

 

4 (incapacitated)

NA

regional lymph nodes

not enlarged (swelling absent)

0

 

enlarged (swelling present)

1

serum CA 19-9

< 1,000 U/mL

0

 

>= 1,000 U/mL

1

from second column, page 492

 

where:

• The index would not apply for a person with ECOG performance status of 3 or 4, as the disease is too advanced and prognosis is poor.

• The normal reference range for serum CA 19-9 is not given.

 

Parameter

Hazard Ratio

95% CI

p value

performance status 2

8.15

2.88 – 23.09

< 0.01

regional lymph node swelling

2.83

1.45 - 5.49

< 0.01

CA 19-9 >= 1,000 U/mL

2.17

1.14 – 4.12

0.02

from Table 3 page 494

 

prognostic index =

= (2.10 * (points for performance status)) + (1.04 * (points for regional lymph nodes)) + (0.77 * (points for CA 19-9))

 

Interpretation:

• minimum index: 0

• maximum score: 3.91

•The higher the score, the shorter the survival

 

Prognostic Index

Group

Median Survival in Days

< 0.7

A

410

0.7 to 1.79

B

239

>= 1.8

C

143

from column 1, page 494


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10