Researchers at the Tianjin Medical University Cancer Institute & Hospital have introduced a new grading system aimed at improving prognosis for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). The Tianjin Grading System, published in Cancer Biology & Medicine in 2025, addresses the limitations of traditional staging methods, such as the TNM classification, which primarily focus on anatomical factors.
While existing systems provide some insights, they often fail to deliver a comprehensive prognosis for PDAC patients, a cancer type known for its aggressive nature and poor survival rates. The Tianjin Grading System enhances patient risk stratification by integrating anatomical, biological, and patient-specific factors. This innovative approach has shown promise in refining treatment strategies and improving patient outcomes.
Innovative Approach to Prognosis
The Tianjin Grading System features a multi-dimensional framework that combines crucial elements such as lymph node metastasis, serum markers like CA19-9, and nutritional status. The system was developed through a retrospective study involving 687 PDAC patients who underwent surgical resection. By analyzing various prognostic factors, researchers identified independent indicators that significantly influence both overall survival (OS) and disease-free survival (DFS).
Patients were categorized into four distinct risk groups: low-risk (0-1), intermediate-risk (2-3), high-risk (4-5), and extremely high-risk (6-10). The findings revealed that survival outcomes varied significantly among these groups, highlighting the need for personalized treatment plans. Notably, those in the high- and extremely high-risk categories experienced substantial benefits from neoadjuvant chemotherapy (NAC).
Dr. Jihui Hao, a leading researcher on the project, stated, “The Tianjin Grading System offers a more accurate way of predicting outcomes for PDAC patients by integrating not just anatomical factors but also biological and patient-specific conditions.” This comprehensive assessment aids healthcare providers in tailoring treatment plans, enhancing survival rates for high-risk patients while ensuring low-risk patients are not subjected to unnecessary treatments.
Clinical Implications and Accessibility
The implications of the Tianjin Grading System extend beyond improved prognosis. By providing a clearer picture of when patients should undergo upfront surgery versus receiving NAC, the system enhances clinical decision-making in managing PDAC. Researchers believe that a more accurate assessment can guide healthcare providers in personalizing care strategies, ultimately leading to better patient outcomes.
Accessibility is another strength of the Tianjin Grading System. It utilizes standard imaging and laboratory tests, making it applicable in various clinical settings, including those with limited resources. This feature positions the grading system as a practical tool for enhancing personalized pancreatic cancer care worldwide.
Funding for this research came from the Tianjin Natural Science Foundation (Grant No. 24JCYBJC00580), underscoring the support for innovative approaches in cancer treatment. As the medical community continues to seek more effective strategies to combat PDAC, the Tianjin Grading System represents a significant step forward in the field.
With a focus on integrating multiple factors for a holistic view of patient prognosis, the Tianjin Grading System promises to reshape how clinicians approach treatment for one of the most challenging cancer types, paving the way for more effective, personalized care.
