Background/Aim: Survival of patients with pancreatic cancer remains poor despite improvements in therapeutic strategies. This study aims to create a novel preoperative score to predict prognosis in patients with tumors of the pancreaticobiliary head. Patients and Methods: Data on 190 patients who underwent to pancreaticoduodenectomy at Sapienza University of Rome from January 2010 to December 2018 were retrospectively analyzed. After exclusion criteria, 101 patients were considered eligible for retrospective study. Preoperative biological, clinical and radiological parameters were considered. Results: Pancreatic ductal adenocarcinoma [hazard ratio (HR)=1.995, 95% confidence intervaI (CI)=1.1-3.3; p=0.01], carbohydrate antigen 19.9 (CA 19.9) >230 U/ml (HR=2.414, 95% CI=2.4-1.5, p<0.0001) and Wirsung duct diameter >3 mm (HR=1.592, 95% CI=1.5-0.9; p=0.08) were the only parameters associated with poor prognosis. Through these parameters, a prognostic score (PHT score) was developed which predicted worst survival when exceeding 2 and better survival when ≤2. Conclusion: The PHT score may have a potential impact on predicting overall survival and consequently modulate the timing and type of treatment (up-front surgery vs. neoadjuvant therapy) patients are offered.

中文翻译：

---

预测胰头腺癌和远端胆管癌患者生存的预后评分

背景/目的：尽管治疗策略有所改进，胰腺癌患者的生存率仍然很低。本研究旨在创建一种新的术前评分来预测胰胆管头部肿瘤患者的预后。患者和方法：回顾性分析了 2010 年 1 月至 2018 年 12 月在罗马 Sapienza 大学接受胰十二指肠切除术的 190 例患者的数据。根据排除标准，101 名患者被认为符合回顾性研究的条件。考虑了术前生物学、临床和放射学参数。结果：胰腺导管腺癌[风险比（HR）=1.995，95%置信区间（CI）=1.1-3.3；p=0.01]，碳水化合物抗原 19.9 (CA 19.9) >230 U/ml（HR=2.414，95% CI=2.4-1.5，p<0.0001）和 Wirsung 导管直径 >3 mm（HR=1.592，95% CI= 1. 5-0.9；p=0.08) 是唯一与不良预后相关的参数。通过这些参数，开发了一个预后评分（PHT 评分），当超过 2 时预测最差的存活率，当≤2 时预测更好的存活率。结论：PHT 评分可能对预测总生存期有潜在影响，并因此调节为患者提供的治疗时间和类型（前期手术与新辅助治疗）。