Impact of Cirrhosis Outcome Risk Estimator Score on Outcomes Following Pancreatectomy for Resectable Pancreatic Ductal Adenocarcinoma

<h3>Background/Aim:</h3> The Cirrhosis Outcome Risk Estimator (CORE) score is a novel model designed to predict the risk of liver disease. However, data regarding the prognostic utility of the CORE score in patients with resectable pancreatic ductal adenocarcinoma (R-PDAC) remain scarce. This study aimed to evaluate the utility of the CORE score as a prognostic stratification tool for R-PDAC. <h3>Patients and Methods:</h3> We retrospectively analyzed 242 patients who underwent pancreatectomy for R-PDAC between January 2009 and December 2023. Patients were stratified into two groups based on their preoperative CORE scores. Multivariate analyses were performed to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS), comparing perioperative outcomes between the groups. <h3>Results:</h3> Of the 242 patients, 73 (30.2%) were classified into the high CORE score group (score &gt;0.9). Patients in the high CORE score group exhibited significantly worse five-year RFS (18.0% <i>vs.</i> 40.1%, <i>p</i>=0.001) and OS (25.9% <i>vs.</i> 51.0%, <i>p</i>=0.001) than those in the low CORE score group. Multivariate analyses identified a low CORE score as an independent predictor of RFS [hazard ratio (HR)=1.53, <i>p</i>=0.014] and OS (HR=1.70, <i>p</i>=0.004). <h3>Conclusion:</h3> The CORE score is a robust, simple preoperative predictor of survival following pancreatectomy for R-PDAC.