Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Eur J Cancer Care (Engl). 2020 May;29(3):e13219. doi: 10.1111/ecc.13219. Epub 2020 Jan 6.
Few studies have evaluated the impact of risk factors and comorbidity on overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). The aim was to investigate the prognostic importance of Charlson's age-comorbidity index (CACI) and other risk factors on prognosis in a clinical real-world cohort of PDAC patients.
A total of 1,159 patients with PDAC who had received at least one cycle of adjuvant or palliative chemotherapy were included from the Danish BIOPAC study. We analysed OS according to CACI, tobacco smoking, alcohol intake, performance status (PS), BMI and diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for OS using Cox proportional hazards regression.
At the end of follow-up, 994 (86%) patients had died. The median OS was 298 days for all patients (range 3-3010) and shortest in patients with stage IV. No association with short OS was seen for CACI > 2, diabetes, alcohol abuse, tobacco smoking, hypertension, and high BMI. Multivariate analysis showed that stage (IV vs. I: HR = 9.05, 95% CI 5.17-15.84), PS (2 vs. 0: HR = 3.67, 2.92-4.61) and treatment with angiotensin-converting enzyme inhibitors (yes vs. no: HR = 1.31, 1.06-1.61) were independent negative prognostic factors.
We found that CACI, diabetes, tobacco smoking, alcohol abuse, hypertension, and high BMI were not associated with OS in a real-world cohort of patients with PDAC treated with chemotherapy. Only stage and PS were prognostic parameters.
很少有研究评估危险因素和合并症对胰腺导管腺癌（PDAC）患者总生存期（OS）的影响。本研究旨在通过丹麦 BIOPAC 研究的真实世界临床队列，探讨 Charlson 合并症指数（CACI）和其他危险因素对 PDAC 患者预后的预测价值。
共纳入 1159 例接受至少 1 个周期辅助或姑息化疗的 PDAC 患者。我们根据 CACI、吸烟、饮酒、体能状态（PS）、BMI 和糖尿病来分析 OS。采用 Cox 比例风险回归估计 OS 的危险比（HR）和 95%置信区间（CI）。
随访结束时，994 例（86%）患者死亡。所有患者的中位 OS 为 298 天（范围 3-3010），IV 期患者最短。CACI>2、糖尿病、酒精滥用、吸烟、高血压和高 BMI 与 OS 短无相关性。多变量分析显示，分期（IV 期比 I 期：HR=9.05，95%CI 5.17-15.84）、PS（2 级比 0 级：HR=3.67，2.92-4.61）和血管紧张素转换酶抑制剂治疗（是比否：HR=1.31，1.06-1.61）是独立的负预后因素。
我们发现，在接受化疗的 PDAC 真实世界临床队列中，CACI、糖尿病、吸烟、酒精滥用、高血压和高 BMI 与 OS 无相关性。只有分期和 PS 是预后参数。
