Evaluation of the MDACC clinical classification system for pancreatic cancer patients in an European multicenter cohort

• Published in: European journal of surgical oncology 2019-05, Vol.45 (5), p.793-799
• Main Authors: Uzunoglu, F.G., Welte, M.-N., Gavazzi, F., Maggino, L., Perinel, J., Salvia, R., Janot, M., Reeh, M., Perez, D., Montorsi, M., Zerbi, A., Adham, M., Uhl, W., Bassi, C., Izbicki, J.R., Malleo, G., Bockhorn, M.
• Format: Article
• Language: English
• Subjects: Europe; Evaluation; MDACC clinical classification; Pancreatic cancer; Type A; Type B; Type C; Upfront surgery
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2018.12.012

The MDACC group recommends to extend the current borderline classification for pancreatic cancer into three groups: type A patients with resectable/borderline tumor anatomy, type B with resectable/borderline resectable tumor anatomy and clinical findings suspicious for extrapancreatic disease and type C with borderline resectable and marginal performance status/severe pre-existing comorbidity profile or age>80. This study intents to evaluate the proposed borderline classification system in a multicenter patient cohort without neoadjuvant treatment. Evaluation was based on a multicenter database of pancreatic cancer patients undergoing surgery from 2005 to 2016 (n = 1020). Complications were classified based on the Clavien-Dindo classification. χ2-test, Kaplan–Meier estimator and Cox regression hazard model were used for statistical analysis. Most patients (55.1%) were assigned as type A patients, followed by type C (35.8%) and type B patients (9.1%). Neither the complication rate, nor the mortality rate revealed a correlation to any subgroup. Type B patients had a significant worse progression free (p