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Notes:
Volume 4 Clinical Pediatric Dermatology
ISSN: 2472-0143
Page 55
JOINT EVENT
Wound Congress 2018 &
Clinical Dermatology Congress 2018
October 15-16, 2018
October 15-16, 2018 Rome, Italy
&
5th International Conference on
Advances in Skin, Wound Care and Tissue Science
14th International Conference on Clinical Dermatology
Development and multicentre validation of a prognostic model to predict resectability of pancreatic
head malignancy
K. Gerke1,2, K. J. Roberts3, B. Reichert4, R. P. Sutcliffe3, F. Marcon3, S. K. Kamarajah3, A. Kaltenborn2, T. Becker4, N. G. Heits4, D. F. Mirzac, J. Klempnauer1
and H. Schrem1 ,2
1Hannover Medical School, Germany
2Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover
3Queen Elizabeth Hospital, UK
4University Medical Centre Schleswig-Holstein, Germany
Statement of the Problem:At the time of planned pancreatoduodenectomy patients frequently undergo exploratory laparotomy
without resection, leading to delayed systemic therapy. This study aimed to develop and validate a prognostic model for the
preoperative prediction of resectability of pancreatic head tumours.
Methodology & Theoretical Orientation: This was a retrospective study of patients undergoing attempted resection for
confirmed malignant tumours of the pancreatic head in a university hospital in Hannover, Germany. The prognostic value
of patient and tumour characteristics was investigated in a multivariable logistic regression model. External validation was
performed using data from two other centres.
Findings: Some 109 patients were included in the development cohort, with 51 and 175 patients in the two validation cohorts.
Eighty patients (73.4%) in the development cohort underwent resection, and 37 (73%) and 141 (80.6%) in the validation
cohorts. The main reasons for performing no resection in the development cohort were: Local invasion of vasculature or
arterial abutment (15 patients, 52%), and liver (12, 41%), peritoneal (8, 28%) and aortocaval lymph node (6, 21%) metastases.
The final model contained the following variables: Time to surgery (OR 0.99, 95 per cent c.i. 0.98 to 0.99), carbohydrate antigen
19-9 concentration (OR 0.99, 0.99 to 0.99), jaundice (OR 4.45, 1.21 to 16.36) and back pain (OR 0.02, 0.00 to 0.22), with an area
under the receiver operating characteristic curve (AUROC) of 0.918 in the development cohort. AUROC values were 0.813
and 0.761 in the validation cohorts. The positive predictive value of the final model for prediction of resectability was 98.0 per
cent in the development cohort, and 91.7 and 94.7 per cent in the two external validation cohorts.
Conclusions: For preoperative prediction of the likelihood of resectability of pancreatic head tumours, this validated model
is a valuable addition to CT findings.
Biography
Konstantin Gerken has been graduated from Hannover Medical School as Medical Doctor. From 2015 to 2017 he has been doing research at the Core Facility
for Quality Management and Health Technology Assessment in Transplantation at Hannover Medical School. Since 2018 he has started working there at the
Department of Anesthesiology and Intensive Care Medicine.
K. Gerke et al., Clin Pediatr Dermatol 2018, Volume 4
DOI: 10.21767/2472-0143-C2-006