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Date: 24 September 2021
Prediction of resectability at the time of planned pancreatoduodenectomy calculator
This calculator was developed to predict the chance of tumour resection with curative intent (i.e. pancreatoduodenectomy) at the time of elective surgery among patients with malignant pancreatic head tumours.
To calculate this chance of resectability please enter the time to surgery, CA19-9 value and report if jaundice or new onset back pain were present.
Please carefully consider the definitions of the variables below to ensure appropriate results.
- Time to surgery (days) – time between the first contact with a local hospital or a physician (e.g a general physicians' or internist’s practice) with symptoms of the present disease which have led to the diagnosis of pancreatic head malignancy and estimated date of surgery
- CA19-9 (kU/L) – most current CA19-9 value not older than 28 days prior to surgery
- Jaundice – presence of jaundice reported at any time prior to surgery
- Back pain – presence of new onset back pain reported at any time prior to surgery
This model was developed using experience in Hannover (Germany) with external validation from patients in Kiel (Germany) and Birmingham (United Kingdom).
This model is not intended to be used in isolation from any other clinical tests or expert judgement. It is provided as an easily applicable additional tool to be used in the preoperative staging process to identify patients that may benefit from further assessments of resectability and to guide discussion with patients and their families.
No test is 100% accurate. This calculator was associated with a large area under the ROC-curve (AUROC) (0.918) in the development cohort. Multicenter external validation revealed AUROCs of 0.813 and 0.761. When the predicted chance of resectability is ≥90% the positive predictive value of the final model for the prediction of resectability was 98.0% in the development and 91.7% as well as 94.7% in the external validation cohorts. Below this value this calculator may not work as well outside of these institutions.