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- W2000953376 abstract "Sir,We enjoyed the article by Strasberg et al. emphasizing the use of jaundice as a prognostic biomarker in patients with resected adenocarcinoma of the pancreas.1 In our attempt to validate these authors’ findings in our own cohort2 of 124 patients resected for pancreatic cancer, we found median survival amounted to 28.5 months in patients without jaundice and 17.9 months in those with jaundice. This difference was not statistically significant, but the findings of Strasberg et al.1 have been validated by other groups.3 Following the approach used by Strasberg et al.,1 we found tumour size, alkaline phosphatase level, tumour–node–metastasis (TNM) stage, grading and margin status to be significant prognostic factors in univariate analyses. When all factors were entered in a multivariate model, grading and margin status remained significant. The prognostic effect of jaundice – when present1,3 – is apparently independent of local obstruction (i.e. tumour size, stenting and nodal status), which suggests the presence of at least some underlying metabolic differences in the liver and/or tumour cells.4The study by Strasberg et al.1 raises another important question. Tumour–node–metastasis staging is probably the most important factor in choosing treatment options and predicting outcome (e.g. determining resectability).5 However, both our own analysis and that of Strasberg et al.1 demonstrate larger effect sizes of other factors, such as grading after resection. Did Strasberg et al.1 include TNM staging in their analyses? The finding that preoperative jaundice status outperforms postoperative staging in predicting outcome would emphasize the clinical relevance of jaundice as a prognostic biomarker." @default.
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- W2000953376 date "2014-02-01" @default.
- W2000953376 modified "2023-09-29" @default.
- W2000953376 title "Jaundice in resected pancreatic cancer patients" @default.
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- W2000953376 doi "https://doi.org/10.1111/hpb.12158" @default.
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