Pooling of prognostic studies in cancer of the pancreatic head and periampullary region: The Triple-P study

C. B. Terwee, E. J.M.N. Van Dijkum, D. J. Gouma*, K. E. Bakkevold, J. H.G. Klinkenbijl, T. P. Wade, B. A. Van Wagensveld, A. Wong, J. H.P. Van der Meulen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: Development of a prognostic tool for patients with unresectable pancreatic cancer to distinguish between with low or high probabilities of survival 3 to 9 months after diagnosis. Design: Data about individual patients from five studies were pooled. A multivariate proportional hazards model with time-dependent covariates was developed, including age, sex, and metastases. An extended model was developed on a subset of patients, including weight loss, pain, and jaundice at diagnosis. Setting: Multicentre study, The Netherlands; Norway, USA, UK, and Canada. Subjects: 1020 patients with unresectable pancreatic cancer. Main outcome measures: Prediction of prognosis. Results: Patients with metastases, pain, or weight loss at diagnosis had a significantly poorer prognosis than the others. Older men had a worse prognosis than younger men, while older women had a better prognosis than younger ones. Patients with jaundice had a relatively good prognosis. Differences in survival among the studies were incorporated in a prognostic score chart. Conclusion: The prognostic score chart can be used to select patients with relatively low expectation of survival for endoscopic palliation, and patients with relatively high expectation for surgical palliation.

Original languageEnglish
Pages (from-to)706-712
Number of pages7
JournalEuropean Journal of Surgery
Issue number9
Publication statusPublished - 2000

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