New Survival Prediction Model for Locally Advanced Pancreatic Cancer

Posted on July 27, 2016

Response: The management of locally advanced pancreatic cancer (LAPC) patients is still controversial. Better discrimination for the prediction of overall survival (OS) at diagnosis is needed. Currently, there is a lack of a staging system and an absence of a consensus regarding patient-specific risk profile for OS that can lead to confusion about the development of research strategy and to potentially inappropriate management of patients with locally advanced pancreatic cancer. What are the main findings?

Response: On the basis of the largest phase III clinical trial of locally advanced pancreatic cancer, we established a novel easy-to-use survival prediction model built on five key parameters (age, albumin, tumour size, CA 19-9 and pain) and provided a prognostic nomogram and score (

The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank P<0.0001). The score ability to discriminate OS was externally confirmed in 106 consecutive locally advanced pancreatic cancer. patients treated in Besancon Hospital, France; median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank P<0.0001). What should readers take away from your report?

Response: In this study, we revealed considerable heterogeneity among locally advanced pancreatic cancer patients regarding their OS-risk profiles with the recognition of clearly different risk groups.

The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC untreated patients and may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future.