TY - JOUR
T1 - Readily available biomarkers predict poor survival in metastatic pancreatic cancer
AU - Strijker, Marin
AU - van Veldhuisen, Eran
AU - van der Geest, Lydia G.
AU - Busch, Olivier R.
AU - Bijlsma, Maarten F.
AU - Haj Mohammad, Nadia
AU - Homs, Marjolein Y.
AU - van Hooft, Jeanin E.
AU - Verheij, Joanne
AU - de Vos-Geelen, Judith
AU - Wilmink, Johanna W.
AU - Steyerberg, W. Ewout W.
AU - Besselink, Marc G.
AU - van Laarhoven, Hanneke W.
AU - Dutch Pancreatic Canc Grp
N1 - Funding Information:
This work was supported by the Dutch Cancer Society [grant number UVA2013-5842]. The authors thank the registration team of the Netherlands Comprehensive Cancer Organization (IKNL) for the collection of data for the Netherlands Cancer Registry.
Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021/5/19
Y1 - 2021/5/19
N2 - BackgroundIdentification of metastatic pancreatic cancer (mPC) patients with the worst prognosis could help to tailor therapy. We evaluated readily available biomarkers for the prediction of 90-day mortality in a nationwide cohort of mPC patients.MethodsPatients with synchronous mPC were included from the Netherlands Cancer Registry (2015-2017). Baseline CA19-9, albumin, CRP, LDH, CRP/albumin ratio, and (modified) Glasgow Prognostic Score ((m)GPS composed of albumin and CRP) were evaluated. Multivariable logistic regression analyses were performed to identify predictors of 90-day mortality. Prognostic value per predictor was quantified by Nagelkerke's partial R-2.ResultsOverall, 4248 patients were included. Median overall survival was 2.2 months and 90-day mortality was 59.4% (n = 1629). All biomarkers predicted 90-day mortality in univariable analysis, and remained statistically significant after adjustment for clinically relevant factors and all other biomarkers (all p < 0.001). The prognostic value of the biomarkers combined was similar to WHO performance status. Patients who received chemotherapy had better outcomes than those who did not, regardless of biomarker levels.ConclusionsIn mPC patients, albumin, CA19-9, CRP, LDH, CRP/albumin ratio, and (m)GPS are prognostic for poor survival. Biomarkers did not predict response to chemotherapy. These readily available biomarkers can be used to better inform patients and to stratify in clinical trials.
AB - BackgroundIdentification of metastatic pancreatic cancer (mPC) patients with the worst prognosis could help to tailor therapy. We evaluated readily available biomarkers for the prediction of 90-day mortality in a nationwide cohort of mPC patients.MethodsPatients with synchronous mPC were included from the Netherlands Cancer Registry (2015-2017). Baseline CA19-9, albumin, CRP, LDH, CRP/albumin ratio, and (modified) Glasgow Prognostic Score ((m)GPS composed of albumin and CRP) were evaluated. Multivariable logistic regression analyses were performed to identify predictors of 90-day mortality. Prognostic value per predictor was quantified by Nagelkerke's partial R-2.ResultsOverall, 4248 patients were included. Median overall survival was 2.2 months and 90-day mortality was 59.4% (n = 1629). All biomarkers predicted 90-day mortality in univariable analysis, and remained statistically significant after adjustment for clinically relevant factors and all other biomarkers (all p < 0.001). The prognostic value of the biomarkers combined was similar to WHO performance status. Patients who received chemotherapy had better outcomes than those who did not, regardless of biomarker levels.ConclusionsIn mPC patients, albumin, CA19-9, CRP, LDH, CRP/albumin ratio, and (m)GPS are prognostic for poor survival. Biomarkers did not predict response to chemotherapy. These readily available biomarkers can be used to better inform patients and to stratify in clinical trials.
KW - Pancreatic cancer
KW - prognosis
KW - readily available biomarkers
KW - GPS
KW - population-based
U2 - 10.1080/1354750x.2021.1893814
DO - 10.1080/1354750x.2021.1893814
M3 - Article
C2 - 33663300
SN - 1354-750X
VL - 26
SP - 325
EP - 334
JO - Biomarkers
JF - Biomarkers
IS - 4
ER -