McGill Brisbane symptom score for patients with resectable pancreatic head adenocarcinoma

Jamal, Mohammed H., Doi, Suhail A. R., Moser, A. James, Dumitra, Sinziana, abou Khalil, Jad, Simoneau, Eve, Chaudhury, Prosanto, Onitilo, Adedayo A., Metrakos, Peter and Barkun, Jeffrey S. (2014) McGill Brisbane symptom score for patients with resectable pancreatic head adenocarcinoma. World Journal of Gastroenterology, 20 34: 12226-12232. doi:10.3748/wjg.v20.i34.12226


Author Jamal, Mohammed H.
Doi, Suhail A. R.
Moser, A. James
Dumitra, Sinziana
abou Khalil, Jad
Simoneau, Eve
Chaudhury, Prosanto
Onitilo, Adedayo A.
Metrakos, Peter
Barkun, Jeffrey S.
Title McGill Brisbane symptom score for patients with resectable pancreatic head adenocarcinoma
Journal name World Journal of Gastroenterology   Check publisher's open access policy
ISSN 1007-9327
2219-2840
Publication date 2014-09
Sub-type Article (original research)
DOI 10.3748/wjg.v20.i34.12226
Open Access Status DOI
Volume 20
Issue 34
Start page 12226
End page 12232
Total pages 7
Place of publication Pleasanton, CA, United States
Publisher Baishideng Publishing Group
Collection year 2015
Language eng
Formatted abstract
Aim: To evaluate the ability of the McGill Brisbane Symptom Score (MBSS) to predict survival in resectable pancreatic head adenocarcinoma (PHA) patients.

Methods: All PHA patients (n = 83) undergoing pancreaticoduodenectomy at the McGill University Health Center, Quebec between 1/2001-1/2010 were evaluated. Data related to patient and cancer characteristics, MBSS variables, and treatment were collected; univariable and multivariable survival analyses were performed. We obtained complete follow-up until February 2011 in all patients through the database of the provincial health insurance plan of Quebec. The unique health insurance numbers of these patients were used to retrieve information from this database which captures all billable clinical encounters, and ensures 100% actual survival data.

Results: Median survival was 23 mo overall: 45 mo for patients with low MBSS, 17 mo for high MBSS (P = 0.005). At twelve months survival was 83.3% (95%CI: 66.6-92.1) vs 58.1% (95%CI: 42.1-71.2) in those with low vs high MBSS, and24 mo survival was 63.8% (95%CI: 45.9-77.1) and 34.0% (95%CI: 20.2-48.2) respectively. In the multivariate Cox model (stratified by chemotherapy), after addition of clinically meaningful covariates, MBSS was the variable with the strongest association with survival (HR = 2.63; P = 0.001). Adjuvant chemotherapy interacted with MBSS category such that only high MBSS patients accrued a benefit. In univariate analysis we found a lower mortality in high MBSS but not low MBSS patients receiving adjuvant chemotherapy. This interaction variable, on Cox model, resulted in an adjusted mortality HR for the high MBSS (compared to low MBSS) of 4.14 (95%CI: 1.48-11.64) without chemotherapy and 2.11 (95%CI: 1.06-4.17) with chemotherapy.

Conclusion: The MBSS is a simple prognostic tool for resectable PHA. Preoperative categorization of patients according to the MBSS allows effective stratification of patients to guide therapy.
Keyword Pancreatic neoplasms
Pancreatic adenocarcinoma
Whipple procedure
Prognosis
Survival study
Chemotherapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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