Effect of MELD-Na score on overall survival of periampullary cancer - Study results

Q: What was the purpose of the study regarding MELD-Na scores?

To investigate how MELD-Na score relates to overall survival in patients undergoing pancreaticoduodenectomy for periampullary cancer.

Q: How many patients were included after applying exclusion criteria?

Eighty patients were included out of 124 after exclusion criteria were applied.

Q: Which factors were independent risk factors for overall survival in multivariate analysis?

MELD-Na score at admission, adjuvant treatment, lymphovascular invasion, and tumor location were independent risk factors.

Sep 21, 2026

Upload by River Wang

Periampullary cancers show short overall survival, and biliary obstruction can impair the liver, kidney, immune system, and cardiovascular status. This retrospective study assessed whether MELD-Na score predicts overall survival after pancreaticoduodenectomy for periampullary cancer. Between January 2010 and January 2021, 80 of 124 patients met criteria. Univariate and multivariate analyses identified MELD-Na at admission, adjuvant treatment, lymphovascular invasion, and tumor location as independent risk factors, supporting MELD-Na as a prognostic tool for surgical patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Methods

Ethical approval and patient selection

Exclusion criteria

Demographic and laboratory data

Calculating MELD-Na score

Updates in Surgery (2024) 76:1819–1825 [https://doi.org/10.1007/s13304-024-01856-w](https://doi.org/10.1007/s13304-024-01856-w) Effect of MELD‑Na score on overall survival of periampullary cancer SerkanYılmaz1 · MesutYur2 Received: 7 October 2023 / Accepted: 10 April 2024 / Published online: 7 May 2024 © The Author(s) 2024 Abstract Periampullary cancers have a short overall survival (OS), and many prognostic factors have been studied for this purpose. They usually present with biliary obstruction, which negatively affects the liver, kidney, immune system, and cardiovascular system. This study aimed to investigate the effect of MELD-Na scores on OS in patients undergoing pancreaticoduodenectomy due to periampullary cancer. Patients who underwent pancreaticoduodenectomy due to periampullary cancer between January 2010 and January 2021 were included in the study. After applying the exclusion criteria, 80 of the 124 patients were included in the study. The demographic, laboratory, and pathologic data of the patients were analyzed retrospectively. Univariate analysis showed that MELD-Na score at admission, age-adjusted Charlson Comorbidity Index, adjuvant treatment, portal vein resection, lymphovascular invasion (LVI), T-stage, and tumor location were significantly associated with OS (p< 0.1) . In multivariate analysis, MELD-Na score at admission (HR: 1.051, 95% CI [1.004–1.101]; p = 0.033), adjuvant treatment (HR: 4.717, 95% CI [2.371–9.383]; p < 0.001), LVI (HR: 2.473, 95% CI [1.355–4.515]; p = 0.003), and tumor location (HR: 2.380, 95% CI [1.274–4.445]; p = 0.007) were independent risk factors for OS. MELD-Na score, adjuvant treatment, LVI, and tumor location were independent risk factors for the OS of periampullary cancer. The MELD-Na score may be used to predict OS for patients undergoing pancreaticoduodenectomy due to periampullary cancer. Keywords MELD-Na score · Pancreatic adenocarcinoma · Pancreaticoduodenectomy Introduction Periampullary cancers (PAC) consist of four types of cancers as localized in the second continent of the duodenum, the ampulla of Vater, the head of the pancreas, and the distal common bile duct [1] . Most patients with PAC present with painless jaundice due to biliary obstruction. At the time of admission, patients are either unresectable or have distant metastases. The most preferred treatment method for operable patients is pancreaticoduodenectomy (PD) . Dr. A. O. Whipple performed the first successful pancreaticoduodenectomy in 1934 [2] . The overall survival (OS) of patients undergoing PD for PAC is significantly longer than in nonoperative patients. The postoperative median OS in PACs was 9.8 months, regardless of location [3] . The * Mesut Yur [myur@firat.edu.tr](myur@firat.edu.tr) 1 Department of Surgical Oncology, Fethi Sekin State Hospital, Elazığ, Turkey 2 Department of Surgical Oncology, Fırat University School of Medicine, 23280 Elazığ, Turkey 5-year survival was found to be 11% in pancreatic head adenocarcinoma and 39% in ampullary cancer [1] . Many studies investigated factors that affected OS in patients who underwent surgery for PAC. Many factors, such as age, CA 19–9, T-stage, N-stage, and adjuvant chemotherapy, were found to be effective in these studies [4, 5] . The model for end-stage liver disease (MELD) scoring was developed to calculate early mortality in patients with chronic liver disease [6] . It is calculated using creatine, international normalized ratio (INR), and bilirubin levels. The MELD-Na score was later developed by incorporating Na+ into the MELD score. This scoring is used to estimate 90-day mortality in chronic liver disease. MELD and MELD-Na scores have been reported to be associated with OS in patients with cirrhosis, hepatocellular carcinoma (HCC), and acid-developing pancreatic and gastric cancer [7–9] . However, the MELD-Na score has not been previously investigated for OS in patients with PAC undergoing PD. This study aimed to i

FAQs

What was the purpose of the study regarding MELD-Na scores?

To investigate how MELD-Na score relates to overall survival in patients undergoing pancreaticoduodenectomy for periampullary cancer.

How many patients were included after applying exclusion criteria?

Eighty patients were included out of 124 after exclusion criteria were applied.

Which factors were independent risk factors for overall survival in multivariate analysis?

MELD-Na score at admission, adjuvant treatment, lymphovascular invasion, and tumor location were independent risk factors.

Sep 21, 2026

Upload by River Wang