Predictors of early mortality in veteran patients with pancreatic cancer

Background: Identification of predictors of outcome may assist in guiding treatment options for patients with pancreatic cancer. The aim of the current study was to determine clinical factors and laboratory values that predicted mortality of less than 6 months in a male population of the same age and body mass index at the time of diagnosis of pancreatic cancer who died as a result of their disease. Methods: Only patients with proven diagnosis of pancreatic cancer (n = 69) were included in the study. Patients were grouped into early (≤6 months; n = 31) and late (>6 months; n = 38) survivors. Forty-four clinical factors were assessed by univariate analysis. Significant factors (P <.05) were included in a multivariate regression model to determine independent predictors of early mortality. Results: All patients in the cohort were men. Both the early and late death cohorts were of similar age and body mass index. Twenty-five patients (36%) underwent surgical intervention (palliative 17%, exploratory laparotomy without resection 6%, pancreaticoduodenectomy 13%). Thirty-six patients (52%) underwent placement of a biliary stent. Eight patients received exclusively palliative care. The mean overall length of survival was 7.8 ± .6 months. Univariate analysis demonstrated that patients who died within 6 months had a significantly increased blood level of carbohydrate antigen 19-9, alkaline phosphatase, and white blood cell (WBC) count. Early mortalities also had a decreased blood albumin level. Multivariate analysis of these factors revealed that low serum albumin and an increased WBC count independently predicted survival of less than 6 months. Conclusion: Serum albumin and WBC count may be used in conjunction with other diagnostic modalities and overall patient status in determining treatment options for patients with pancreatic cancer.