Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection

Robert M. Cannon; Ryan LeGrand; Ryaz B. Chagpar; Syed A. Ahmad; Rebecca McClaine; Hong Jin Kim; Christopher Rupp; Cliff S. Cho; Adam Brinkman; Sharon Weber; Emily R. Winslow; David A. Kooby; Carrie K. Chu; Charles A. Staley; Ian Glenn; William G. Hawkins; Alexander A. Parikh; Nipun B. Merchant; Kelly M. McMasters; Robert C.G. Martin; Glenda G. Callender; Charles R. Scoggins

doi:10.1111/j.1477-2574.2011.00432.x

Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection

Robert M. Cannon, Ryan LeGrand, Ryaz B. Chagpar, Syed A. Ahmad, Rebecca McClaine, Hong Jin Kim, Christopher Rupp, Cliff S. Cho, Adam Brinkman, Sharon Weber, Emily R. Winslow, David A. Kooby, Carrie K. Chu, Charles A. Staley, Ian Glenn, William G. Hawkins, Alexander A. Parikh, Nipun B. Merchant, Kelly M. McMasters, Robert C.G. MartinGlenda G. Callender, Charles R. Scoggins

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43 Scopus citations

Abstract

Background: The effect of diabetes on survival after resection pancreatic ductal carcinoma (PDAC) is unclear. The present study was undertaken to determine whether pre-operative diabetes has any predictive value for survival. Methods: A retrospective review from seven centres was performed. Metabolic factors, tumour characteristics and outcomes of patients undergoing resection for PDAC were collected. Univariate and multivariable analyses were performed to determine factors associated with disease-free (DFS) and overall survival (OS). Results: Of the 509 patients in the present study, 31.2% had diabetes. Scoring systems were devised to predict OS and DFS based on a training set (n = 245) and were subsequently tested on an independent set (n = 264). Pre-operative diabetes (P < 0.001), tumour size >2 cm (P = 0.001), metastatic nodal ratio >0.1 (P < 0.001) and R1 margin (P < 0.001) all correlated with DFS and OS on univariate analysis. Scoring systems were devised based on multivariable analysis of the above factors. Diabetes and the metastatic nodal ratio were the most important factors in each system, earning two points for OS and four points for DFS. These scoring systems significantly correlated with both DFS (P < 0.001) and OS (P < 0.001). Conclusion: Pre-operative diabetes status provides useful information that can help to stratify patients in terms of predicted post-operative OS and DFS.

Original language	English
Pages (from-to)	228-235
Number of pages	8
Journal	HPB
Volume	14
Issue number	4
DOIs	https://doi.org/10.1111/j.1477-2574.2011.00432.x
State	Published - Apr 2012

Keywords

Diabetes mellitus
Disease-free survival
Lymph node ratio
Margin
Multivariable analysis
Prognostic factors
Prognostic nomogram

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10.1111/j.1477-2574.2011.00432.x

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Cannon, R. M., LeGrand, R., Chagpar, R. B., Ahmad, S. A., McClaine, R., Kim, H. J., Rupp, C., Cho, C. S., Brinkman, A., Weber, S., Winslow, E. R., Kooby, D. A., Chu, C. K., Staley, C. A., Glenn, I., Hawkins, W. G., Parikh, A. A., Merchant, N. B., McMasters, K. M., ... Scoggins, C. R. (2012). Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection. HPB, 14(4), 228-235. https://doi.org/10.1111/j.1477-2574.2011.00432.x

@article{044f21aa0679426fb276c3ac7ae0eb3f,

title = "Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection",

abstract = "Background: The effect of diabetes on survival after resection pancreatic ductal carcinoma (PDAC) is unclear. The present study was undertaken to determine whether pre-operative diabetes has any predictive value for survival. Methods: A retrospective review from seven centres was performed. Metabolic factors, tumour characteristics and outcomes of patients undergoing resection for PDAC were collected. Univariate and multivariable analyses were performed to determine factors associated with disease-free (DFS) and overall survival (OS). Results: Of the 509 patients in the present study, 31.2% had diabetes. Scoring systems were devised to predict OS and DFS based on a training set (n = 245) and were subsequently tested on an independent set (n = 264). Pre-operative diabetes (P < 0.001), tumour size >2 cm (P = 0.001), metastatic nodal ratio >0.1 (P < 0.001) and R1 margin (P < 0.001) all correlated with DFS and OS on univariate analysis. Scoring systems were devised based on multivariable analysis of the above factors. Diabetes and the metastatic nodal ratio were the most important factors in each system, earning two points for OS and four points for DFS. These scoring systems significantly correlated with both DFS (P < 0.001) and OS (P < 0.001). Conclusion: Pre-operative diabetes status provides useful information that can help to stratify patients in terms of predicted post-operative OS and DFS.",

keywords = "Diabetes mellitus, Disease-free survival, Lymph node ratio, Margin, Multivariable analysis, Prognostic factors, Prognostic nomogram",

author = "Cannon, {Robert M.} and Ryan LeGrand and Chagpar, {Ryaz B.} and Ahmad, {Syed A.} and Rebecca McClaine and Kim, {Hong Jin} and Christopher Rupp and Cho, {Cliff S.} and Adam Brinkman and Sharon Weber and Winslow, {Emily R.} and Kooby, {David A.} and Chu, {Carrie K.} and Staley, {Charles A.} and Ian Glenn and Hawkins, {William G.} and Parikh, {Alexander A.} and Merchant, {Nipun B.} and McMasters, {Kelly M.} and Martin, {Robert C.G.} and Callender, {Glenda G.} and Scoggins, {Charles R.}",

year = "2012",

month = apr,

doi = "10.1111/j.1477-2574.2011.00432.x",

language = "English",

volume = "14",

pages = "228--235",

journal = "HPB",

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Cannon, RM, LeGrand, R, Chagpar, RB, Ahmad, SA, McClaine, R, Kim, HJ, Rupp, C, Cho, CS, Brinkman, A, Weber, S, Winslow, ER, Kooby, DA, Chu, CK, Staley, CA, Glenn, I, Hawkins, WG, Parikh, AA, Merchant, NB, McMasters, KM, Martin, RCG, Callender, GG & Scoggins, CR 2012, 'Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection', HPB, vol. 14, no. 4, pp. 228-235. https://doi.org/10.1111/j.1477-2574.2011.00432.x

TY - JOUR

T1 - Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection

AU - Cannon, Robert M.

AU - LeGrand, Ryan

AU - Chagpar, Ryaz B.

AU - Ahmad, Syed A.

AU - McClaine, Rebecca

AU - Kim, Hong Jin

AU - Rupp, Christopher

AU - Cho, Cliff S.

AU - Brinkman, Adam

AU - Weber, Sharon

AU - Winslow, Emily R.

AU - Kooby, David A.

AU - Chu, Carrie K.

AU - Staley, Charles A.

AU - Glenn, Ian

AU - Hawkins, William G.

AU - Parikh, Alexander A.

AU - Merchant, Nipun B.

AU - McMasters, Kelly M.

AU - Martin, Robert C.G.

AU - Callender, Glenda G.

AU - Scoggins, Charles R.

PY - 2012/4

Y1 - 2012/4

N2 - Background: The effect of diabetes on survival after resection pancreatic ductal carcinoma (PDAC) is unclear. The present study was undertaken to determine whether pre-operative diabetes has any predictive value for survival. Methods: A retrospective review from seven centres was performed. Metabolic factors, tumour characteristics and outcomes of patients undergoing resection for PDAC were collected. Univariate and multivariable analyses were performed to determine factors associated with disease-free (DFS) and overall survival (OS). Results: Of the 509 patients in the present study, 31.2% had diabetes. Scoring systems were devised to predict OS and DFS based on a training set (n = 245) and were subsequently tested on an independent set (n = 264). Pre-operative diabetes (P < 0.001), tumour size >2 cm (P = 0.001), metastatic nodal ratio >0.1 (P < 0.001) and R1 margin (P < 0.001) all correlated with DFS and OS on univariate analysis. Scoring systems were devised based on multivariable analysis of the above factors. Diabetes and the metastatic nodal ratio were the most important factors in each system, earning two points for OS and four points for DFS. These scoring systems significantly correlated with both DFS (P < 0.001) and OS (P < 0.001). Conclusion: Pre-operative diabetes status provides useful information that can help to stratify patients in terms of predicted post-operative OS and DFS.

AB - Background: The effect of diabetes on survival after resection pancreatic ductal carcinoma (PDAC) is unclear. The present study was undertaken to determine whether pre-operative diabetes has any predictive value for survival. Methods: A retrospective review from seven centres was performed. Metabolic factors, tumour characteristics and outcomes of patients undergoing resection for PDAC were collected. Univariate and multivariable analyses were performed to determine factors associated with disease-free (DFS) and overall survival (OS). Results: Of the 509 patients in the present study, 31.2% had diabetes. Scoring systems were devised to predict OS and DFS based on a training set (n = 245) and were subsequently tested on an independent set (n = 264). Pre-operative diabetes (P < 0.001), tumour size >2 cm (P = 0.001), metastatic nodal ratio >0.1 (P < 0.001) and R1 margin (P < 0.001) all correlated with DFS and OS on univariate analysis. Scoring systems were devised based on multivariable analysis of the above factors. Diabetes and the metastatic nodal ratio were the most important factors in each system, earning two points for OS and four points for DFS. These scoring systems significantly correlated with both DFS (P < 0.001) and OS (P < 0.001). Conclusion: Pre-operative diabetes status provides useful information that can help to stratify patients in terms of predicted post-operative OS and DFS.

KW - Diabetes mellitus

KW - Disease-free survival

KW - Lymph node ratio

KW - Margin

KW - Multivariable analysis

KW - Prognostic factors

KW - Prognostic nomogram

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DO - 10.1111/j.1477-2574.2011.00432.x

M3 - Article

C2 - 22404260

AN - SCOPUS:84862822934

SN - 1365-182X

VL - 14

SP - 228

EP - 235

JO - HPB

JF - HPB

IS - 4

ER -

Multi-institutional analysis of pancreatic adenocarcinoma demonstrating the effect of diabetes status on survival after resection

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Keywords

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