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Adding Grade Status to Staging Improves Prognostic Capability in Pancreatic Cancer

The pancreatic cancer surgical (and oncology) team at UCLA developed a new experimental staging method such that the tumor’s grade was added to the standard (TNM) AJCC staging criteria, whereby a high-grade tumor increased the pancreatic cancer stage (ductal adenocarcinoma of the pancreas) to the next higher level than would have been otherwise indicated.

Published in the December issue of the Annals of Surgical Oncology, the study at hand is essentially an attempt at a proof of this concept related to these novel pancreatic cancer stages.  In passing, one might remark that these UCLA researchers must be utilizing Big Data, as many of the team are the same as on another recent intriguing large concept study that the Pancreatica Blog commented on involving prolonged neoadjuvant therapy for pancreatic cancer.

The authors reviewed the records and pathology results of patients who underwent pancreatic cancer resection at UCLA from 1990 until 2006, identifying 256 individuals. These patients’ disease were then re-staged using the new staging schema, and the disease outcomes were examined.

The authors found that low-grade tumors gave about a 13 month median survival advantage as compared to high-grade tumors.  They found that adding grade to the traditional TMN criteria in the staging of pancreatic cancer gave a more precise and discriminatory survival element to the staging system.

The researchers suggest that the addition of tumor grade to the staging of pancreatic cancer be considered.

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Dale O’Brien, MD