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Adjuvant Therapy for Resectable Pancreatic Cancer: A Simple Prediction Rule

J. K. Smith, S. C. Ng, J. P. Simons, Z. Zhou, S. A. Shah, T. P. McDade, J. F. Tseng, University of Massachusetts Medical School, Surgical Outcomes Analysis and Research, Worcester, MA


Follow the steps below to calculate the risk of a patient not being able to complete adjuvant therapy following a pancreatic resection for cancer.

Step 1. Calculate Charlson comorbidity score
Indicate "yes" for the comorbidities that the patient has. This validated algorithm (Charlson, ME et al. J Chron Dis 1987; 40(5):373-83.) assigns a point value to the various diseases. The patient's raw score will then be reassigned into the collapsed Charlson score groups for use in the risk score calculation. Group 1 is a score of zero, Group 2 is a score of 1 or 2, Group 3 is a score of 3 or higher.  



Cerebrovascular Disease   
Chronic Pulmonary Disease   
Congestive Heart Failure   
Connective Tissue/Rheumatic Disease   
Diabetes Without End Organ Damage   
Diabetes With End Organ Damage   
Liver Disease Mild to Moderate   
Liver Disease Severe   
Myocardial Infarction   
Peripheral Vascular Disease   
Renal Disease   
Ulcer Disease   
Charlson Group Score


Step 2. Calculate the risk score, including the Charlson group.
Patient age, Charlson score group, planned procedure type, gender, and the teaching status of the hospital are indicated.  The point values are assigned accordingly to yield an additive score.  By clicking on the "Calculate Risk of Not Receiving Adjuvant Therapy" button, this score is then assigned to the appropriate risk score group, and the percentage of that group not receiving adjuvant therapy is displayed.



Point Value

Age Group     
Charlson Score Group
Procedure Type     
Hospital Type     



Risk Score updated 03052010 

Fig. 1: Risk of not receiving adjuvant therapy

As demonstrated in the above graph, as the risk score increases, the probability that the patient does not receive adjuvant therapy also increases.

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