• Tokushukai REAl-world Data project
• cancer-associated thromboembolism
• metastatic pancreatic cancer
• real-world data
• venous thromboembolism

• Advanced cancer
• Inflammation
• Nutrition
• Pancreatic cancer
• Prognostic factor
• Systemic inflammatory response index
• Weight loss

• blood urea nitrogen
• lung cancer
• outcomes
• pulmonary lobectomy
• robotic surgery
• serum albumin

Pancreatic adenocarcinoma is a highly aggressive malignancy that presents a considerable risk of early death (survival time ≤ 3 mo). As such, it is of great significance to develop an effective nomogram for predicting the likelihood of early death in patients with metastatic pancreatic adenocarcinoma.

To construct and validate a predictive nomogram model for early death in patients with metastatic pancreatic adenocar-cinoma.

We extracted data from the SEER database of 18603 eligible patients with metastatic pancreatic adenocarcinoma from 2010 to 2015, and randomly divided them into training and validation cohorts in a 7:3 ratio. Univariate and multivariate logistic regression analyses were performed on the training cohort to identify the risk factors for early death, based on which a nomogram was constructed. The performance of the nomogram was verified by receiver operating characteristic (ROC) curve and calibration curve analyses in both the training and validation cohorts. The clinical practicability of the nomogram was evaluated by decision curve analysis (DCA).

Age, sex, primary site, grade, T stage, N stage, brain metastasis, bone metastasis, liver metastasis, lung metastasis, surgery, radiotherapy, and chemotherapy were identified as independent risk factors for early death in patients with metastatic pancreatic adenocarcinoma. Based on these variables, a nomogram was constructed. The areas under the ROC curves of the nomogram in the training and validation cohorts were 0.810 (95% confidence interval [CI]: 0.802-0.811) and 0.802 (95%CI: 0.790-0.813), respectively, indicating good discrimination. The calibration curves showed good calibration degrees in both cohorts, and the DCA results demonstrated that the nomogram had better clinical net benefit in predicting early mortality compared with TNM stage.

The constructed nomogram has good predictive ability for early death in patients with metastatic pancreatic adeno-carcinoma. This will help clinicians develop individualized treatment plans for these patients.

• Pancreatic adenocarcinoma
• SEER
• Nomogram
• Early death

Pancreatic ductal adenocarcinoma is a highly fatal malignancy. The aim was to identify preoperative factors for early mortality in up-front resectable patients following pancreatoduodenectomy (PD) and develop an early mortality risk score.

Patients registered in the Swedish National Registry for Pancreatic and Periampullary Cancer were included. Relevant preoperative factors (n = 21) were investigated. Early mortality was defined as death within 12 months after surgery. Based on the identified risk factor odds ratios (ORs), the Score Predicting Early Mortality (SPEM) was developed.

In total, 2183 PDs were performed, and 926 patients met the study criteria. The mean age was 68 (SD ± 8.8) years, and 48% were female. A total of 233 (24%) patients died within 12 months. In the multivariable analyses, age > 75 years (OR 1.7; 95% CI 1.1–2.4; p = 0.008), CRP ≥ 15 mg/L (OR 2.0; 95% CI 1.3–3.1; p = 0.001), CA 19-9 > 500 U/mL (OR 1.8; 95% CI 1.0–3.2; p = 0.040), diabetes mellitus (OR 1.40; 95% CI 1.00–2.1; p = 0.042), and active smoking (OR 1.47; 95%CI 1.00–2.00; p = 0.050) were found to be independent risk factors for early mortality.

Five independent preoperative risk factors for early mortality following PD were identified and together formed SPEM. The score might be a useful tool in establishing individualized treatment plans.

• Aged
• Carcinoma, Pancreatic Ductal/surgery
• Cohort Studies
• Female
• Humans
• Male
• Pancreatic Neoplasms/pathology
• Retrospective Studies
• Risk Factors

• Lund University

• early death
• pancreatic ductal adenocarcinoma
• predictive model
• resectable

• Adenocarcinoma/pathology
• Carcinoma, Pancreatic Ductal
• Humans
• Neoadjuvant Therapy
• Pancreatic Neoplasms/pathology
• Retrospective Studies

• National Natural Science Foundation of China
• Natural Science Foundation of Beijing Municipality

Pancreatic adenocarcinoma (PCa) is a highly aggressive malignancy with high risk of early death (survival time ≤3 months). The present study aimed to identify associated risk factors and develop a simple-to-use nomogram to predict early death in metastatic PCa patients.

Patients diagnosed with metastatic PCa between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were collected for model construction and internal validation. An independent data set was obtained from China for external validation. Independent risk variables contributed to early death were identified by logistic regression models, which were then used to construct a nomogram. Internal and external validation was performed to evaluate the nomogram using calibration curves and the receiver operating characteristic curves.

A total of 19,464 patients in the SEER cohort and 67 patients in the Chinese cohort were included. Patients from the SEER database were randomly divided into the training cohort (n = 13,040) and internal validation cohort (n = 6,424). Patients in the Chinese cohort were selected for the external validation cohort. Overall, 10,484 patients experienced early death in the SEER cohort and 35 in the Chinese cohort. A reliable nomogram was constructed on the basis of 11 significant risk factors. Internal validation and external validation of the nomogram showed high accuracy in predicting early death. Decision curve analysis demonstrated that this predictive nomogram had excellent and potential clinical applicability.

The nomogram provided a simple-to-use tool to distinguish early death in patients with metastatic PCa, assisting clinicians in implementing individualized treatment regimens.

• SEER database
• early death
• nomogram
• pancreatic adenocarcinoma
• prognosis

• chemotherapy
• lung cancer
• pulmonary embolism
• risk assessment

• Aged
• Anticoagulants/therapeutic use
• Drug Therapy/methods
• Female
• Humans
• Incidence
• Inpatients
• Lung Neoplasms/complications
• Lung Neoplasms/drug therapy
• Male
• Middle Aged
• Neoplasm Staging
• Pulmonary Embolism/epidemiology
• Pulmonary Embolism/etiology
• Pulmonary Embolism/prevention & control
• Retrospective Studies
• Risk Assessment

• extrapancreatic neuropathy
• liver metastasis
• parasympathetic neurogenesis
• resectable pancreatic head adenocarcinoma
• superior mesenteric artery

Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer often diagnosed late. Earlier detection is urgently needed. Pancreatic ductal adenocarcinoma is known to associate with increased coagulation activity. We studied whether preoperative coagulation biomarkers are useful in distinguishing PDAC from a benign tumor, intraductal papillary mucinous neoplasm (IPMN) in this observational study. We analyzed standard clinical and coagulation variables in patients operated during 2010 and 2015 at Helsinki University Hospital. Pancreatic ductal adenocarcinoma with preoperative coagulation variables available and no neoadjuvant treatment or other active cancer was observed in 80 patients (stage I-III in 67 and IV in 13) and IPMN in 18 patients. Fibrinogen, factor VIII (FVIII), carbohydrate antigen (CA) 19-9, albumin, alkaline phosphatase, and conjugated bilirubin were higher in both stages I to III and IV PDAC compared to IPMN (P < .05). Factor VIII was highest in stage IV (P < .05). Combining these variables in a panel increased sensitivity and specificity for PDAC. In receiver operating characteristic analysis, the area under the curve (95% confidence interval) was 0.95 (0.90-1.00) for the panel, compared to 0.80 (0.71-0.88) for CA 19-9 alone (P < .01). In conclusion, PDAC was associated with increased fibrinogen and FVIII. Combining these coagulation biomarkers with CA 19-9, albumin, and alkaline phosphatase improves diagnostic accuracy.

• CA 19-9
• FVIII
• biomarker
• coagulation
• fibrinogen
• pancreatic cancer

• Khorana score
• chemotherapy
• lung cancer
• venous thromboembolism

• Adenocarcinoma of Lung/drug therapy
• Adenocarcinoma of Lung/mortality
• Aged
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/mortality
• Chemotherapy, Adjuvant/adverse effects
• Chemotherapy, Adjuvant/methods
• Disease-Free Survival
• Female
• Humans
• Lung Neoplasms/drug therapy
• Lung Neoplasms/mortality
• Male
• Middle Aged
• Risk Factors
• Survival Rate
• Venous Thromboembolism/chemically induced
• Venous Thromboembolism/mortality

• Hodgkin lymphoma
• Khorana Risk Score
• ThroLy Score
• mean platelet volume
• venous thromboembolism

• Diffuse large B cell lymphoma
• Hodgkin lymphoma
• Khorana Risk Score
• Venous thromboembolism

Early mortality is a major problem in colorectal cancer (CRC). We have shown that Khorana Score is predictive of early mortality in other cancers. Here, we evaluated the value of this score and other prognostic variables in predicting early mortality in CRC.

CANTARISK was a prospective, noninterventional, global cohort study in patients with CRC initiating a new chemotherapy regimen. Data were collected at zero, two, four, and six months. Early mortality was defined as death within six months of enrollment. All data were compiled centrally and analyzed after the study closed. Statistically significant univariate associations were tested in multivariable models; adjusted odds ratios (ORs) are presented. Statistical tests were two-sided.

From 2011 to 2012, 1789 CRC patients were enrolled. The median age was 62 years; 71% were Caucasian. One-third (35%) had a rectal primary, and 65% had metastatic disease. There were 184 (10.3%) patients who died during their first six months in the study. For low, intermediate, and high Khorana Score, there were 8.1%, 11.2% and 32.5% deaths, respectively. In multivariable analyses, Khorana Score was an independent predictor of early death (OR for high/intermediate vs low score = 1.70, P = .0027), in addition to age (OR for each incremental year = 1.03, P = .0014), presence of metastatic disease (OR = 3.28, P < .0001), and Easter Cooperative Oncology Group Performance Status Score of 2 or higher (OR = 3.85, P < .0001).

This study demonstrates that Khorana Score is predictive of early mortality in CRC patients. Intermediate- or high-risk patients, as defined by this score, may benefit from additional interventions aimed at reducing early mortality.

• Early mortality
• Pancreatic ductal carcinoma
• Predictive score
• Survival

• Khorana score
• hepatocellular carcinoma
• venous thromboembolism

• Cancer
• mortality
• prediction
• recurrences
• venous thrombosis

The first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation might cause early recurrence. The present study aimed to identify preoperative clinicopathological features of early recurrence after curative resection of RPC.

Ninety RPC patients who underwent curative resection between 2000 and 2014 at our institution were retrospectively analyzed.

Of the 90 patients, 32 had recurrence within 1 year. Univariate analysis demonstrated that preoperative serum carbohydrate antigen (CA19-9) ≥529 U/mL (P = 0.0011), preoperative serum s-pancreas-1 antigen (SPan-1) ≥37 U/mL (P = 0.0038), and histological grades G2–G4 (P = 0.0158) were significantly associated with recurrence within 1 year after curative resection. Multivariate analysis demonstrated that preoperative serum CA19-9 ≥ 529 U/mL (P = 0.0477) and histological grade G2–G4 (P = 0.0129) were independent predictors of recurrence within 1 year. Recurrent cases within 1 year postoperatively had significantly more distant metastasis than cases with no recurrence within 1 year (P < 0.001).

Preoperative serum CA19-9 ≥ 529 U/mL and histological grades G2–G4 were independent predictive factors for recurrence within 1 year after pancreatectomy for RPC. Furthermore, recurrent cases within 1 year had more frequent distant metastasis than cases with no recurrence within 1 year. These results suggest that RPC patients with preoperative serum CA19-9 ≥ 529 U/mL should receive preoperative therapy rather than surgery.

• CA19-9
• Histological grade
• Preoperative predictors
• Resectable pancreatic cancer
• Tumor diameter

• lung cancer
• mortality
• prediction score
• prevention
• venous thromboembolism

• Aged
• Anticoagulants/therapeutic use
• Carcinoma, Non-Small-Cell Lung/complications
• Carcinoma, Non-Small-Cell Lung/diagnosis
• Carcinoma, Non-Small-Cell Lung/therapy
• Female
• Humans
• Incidence
• Lung Neoplasms/complications
• Lung Neoplasms/diagnosis
• Lung Neoplasms/therapy
• Male
• Middle Aged
• Multivariate Analysis
• Prospective Studies
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome
• Venous Thromboembolism/complications
• Venous Thromboembolism/diagnosis
• Venous Thromboembolism/therapy

• K12 CA090628 NCI NIH HHS
• R01 CA084354 NCI NIH HHS
• R01 CA115857 NCI NIH HHS
• R03 CA077118 NCI NIH HHS

The association between baseline renal impairment (RI) and the prognosis of diffuse large B-cell lymphoma (DLBCL) was previously not defined. The aim of this study was to evaluate the prognostic value of RI in patients with DLBCL treated with three-weekly rituximab plus cyclophosphamide, Adriamycin, vincristine, and prednisolone immunochemotherapy (R-CHOP21).

Patients with newly diagnosed de novo DLBCLs treated with ≥1 cycle of R-CHOP21 were analyzed retrospectively. Pretreatment blood samples were collected and the glomerular filtration rate (GFR) was calculated. RI was defined by a GFR of <60 mL/min/1.73 m² according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.

Of the 185 patients enrolled in the present study, 19 patients (10.3%) had RI. The reasons for baseline RI were pre-existing CKD (N=5), acute kidney injury due to either obstruction (N=2) or electrolyte imbalance (N=2) related to DLBCL, and undefined causes (N=10). Patients with baseline RI showed inferior overall survival (OS) compared to those without RI (P<0.001). In multivariate analysis, RI was identified as an International Prognostic Index (IPI)-independent prognostic indicator. A baseline hemoglobin level of <10 g/dL and the presence of RI effectively discriminated a portion of the patients with far inferior event-free survival and OS among the patients having high or high-intermediate risk cancers according to either the standard- or the National Comprehensive Cancer Network-IPI.

Pretreatment RI was an independent prognostic marker for inferior OS in patients with DLBCL treated with R-CHOP21 immunochemotherapy.

• Diffuse large B-cell lymphoma
• Prognosis
• Renal insufficiency
• Rituximab

• CA19-9 antigen
• pancreatic adenocarcinoma
• pancreatic neoplasms
• predictor of mortality
• veteran

• Animals
• Diabetes Complications/microbiology
• Diabetes Mellitus/microbiology
• Disease Progression
• Gastrointestinal Microbiome
• Homeostasis
• Humans
• Inflammation
• Pancreas/physiology
• Pancreatic Neoplasms/microbiology
• Pancreatitis/microbiology
• Patient Safety