{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:51:11Z","timestamp":1791165071017,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The PANAMA score was developed as a post\u2010NAT prognostic tool for PDAC. Prior validations have been dominated by pancreatic head cancers. Pancreatic body and tail tumours represent a biologically distinct subgroup and remain underrepresented in NAT cohorts. Whether the score reliably predicts outcomes in distal PDAC remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted at a single centre including patients with PDAC who received NAT followed by distal pancreatectomy between January 2015 and December 2024. Patients were stratified into low\u2010, intermediate\u2010 and high\u2010risk groups based on the original PANAMA score. Overall survival (OS) and disease\u2010free survival (DFS) were assessed. Prognostic performance of the PANAMA score and AJCC staging was compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two patients were included. Median OS and DFS were 40.8 months (95% CI: 28.7\u201355.0) and 11.6 months (95% CI: 9.7\u201314.5), respectively. High\u2010risk patients showed worse OS compared to intermediate\u2010 and low\u2010risk groups (21.8, 31.1 and 55.0 months, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). A similar pattern was observed for DFS (10.3, 11.2 and 29.2\u2009months, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). The AJCC stage outperformed the PANAMA score in OS prediction (\n                      <jats:italic>C<\/jats:italic>\n                      \u2010index 0.70 vs. 0.64).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PANAMA score effectively stratifies patients with pancreatic body and tail PDACs undergoing neoadjuvant therapy and resection into prognostic groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70999","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:56:26Z","timestamp":1791161786000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the\n                    <scp>PANAMA<\/scp>\n                    Score in Patients With Pancreatic Ductal Adenocarcinoma Undergoing Distal Pancreatectomy"],"prefix":"10.1111","author":[{"given":"Simeng","family":"Li","sequence":"first","affiliation":[{"name":"Sydney Medical School, University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4438-9989","authenticated-orcid":false,"given":"Hiro","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1558-8607","authenticated-orcid":false,"given":"Krishna","family":"Kotecha","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-4285","authenticated-orcid":false,"given":"Nazim","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Pavlakis","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Medical Oncology Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Clarke","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Medical Oncology Royal North Shore Hospital  St Leonards 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-7343","authenticated-orcid":false,"given":"Kai","family":"Brown","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6664-7147","authenticated-orcid":false,"given":"Jaswinder","family":"Samra","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  St Leonards 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T.","year":"2025","journal-title":"World Journal of Clinical Oncology"},{"issue":"1","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.21037\/hbsn.2019.08.01","article-title":"Modification of the 8th AJCC Staging System of Pancreatic Ductal Adenocarcinoma","volume":"9","author":"Nagaria T. S.","year":"2020","journal-title":"Hepatobiliary Surgery and Nutrition"},{"issue":"8","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1097\/PAS.0000000000000887","article-title":"Prognostic Significance of New AJCC Tumor Stage in Patients With Pancreatic Ductal Adenocarcinoma Treated With Neoadjuvant Therapy","volume":"41","author":"Chatterjee D.","year":"2017","journal-title":"American Journal of Surgical Pathology"},{"issue":"2","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/SLA.0000000000004143","article-title":"A Combination of Biochemical and Pathological Parameters Improves Prediction of Postresection Survival After Preoperative Chemotherapy in Pancreatic Cancer: The PANAMA\u2010Score","volume":"275","author":"Hank T.","year":"2022","journal-title":"Annals of Surgery"},{"issue":"5","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1097\/SLA.0000000000006650","article-title":"Validation of the PANAMA Score for Survival and Benefit of Adjuvant Therapy in Patients With Resected Pancreatic Cancer After Neoadjuvant FOLFIRINOX","volume":"281","author":"Rompen I. 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