Department of General Surgery, Shengjing Hospital of China Medical University, 110004, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning Province, China.
World J Surg Oncol. 2022 Jan 7;20(1):11. doi: 10.1186/s12957-021-02478-x.
The overall survival of patients with pancreatic cancer is extremely low. Despite multiple large-scale studies, identification of predictors of patient survival remains challenging. This study aimed to investigate the prognostic factors for pancreatic cancer.
The clinical data of 625 patients with pancreatic cancer treated at Shengjing Hospital of China Medical University from January 2013 to December 2017 were collected.
Of 625 patients, 569 were followed from 1 to 75 months. The median overall survival was 9.3 months. The overall 1-, 3-, and 5-year survival rates were 37.8%, 15.1%, and 10.5%, respectively. Cox proportional hazards model indicated that baseline carbohydrate antigen 199 level, neutrophil-lymphocyte ratio, operative procedure, lymph node metastasis, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of patients with pancreatic cancer. Baseline carbohydrate antigen 199 level, degree of weight loss, operative procedure, lymph node metastasis, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of pancreatic head cancer subgroup. Baseline carbohydrate antigen 199 level, carcinoembryonic antigen level, total bilirubin level, neutrophil-lymphocyte ratio, peripancreatic invasion, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of the pancreatic body/tail cancer subgroup.
Higher carbohydrate antigen 199 levels, neutrophil-lymphocyte ratio, lymph node metastasis and distant organ metastasis predict a poor prognosis in patients with pancreatic cancer. Early detection, early radical surgery and adjuvant chemotherapy are needed to improve prognosis for this deadly disease.
胰腺癌患者的总体生存率极低。尽管进行了多项大规模研究，但识别患者生存的预测因素仍然具有挑战性。本研究旨在探讨胰腺癌的预后因素。
收集了中国医科大学盛京医院 2013 年 1 月至 2017 年 12 月收治的 625 例胰腺癌患者的临床资料。
625 例患者中，569 例患者的随访时间为 1 至 75 个月。中位总生存期为 9.3 个月。总 1 年、3 年和 5 年生存率分别为 37.8%、15.1%和 10.5%。Cox 比例风险模型表明，基线癌抗原 199 水平、中性粒细胞与淋巴细胞比值、手术方式、淋巴结转移、远处器官转移数量和术后辅助化疗是胰腺癌患者的独立预后因素。基线癌抗原 199 水平、体重减轻程度、手术方式、淋巴结转移、远处器官转移数量和术后辅助化疗是胰头癌亚组的独立预后因素。基线癌抗原 199 水平、癌胚抗原水平、总胆红素水平、中性粒细胞与淋巴细胞比值、胰周侵犯、远处器官转移数量和术后辅助化疗是胰体/尾癌亚组的独立预后因素。
较高的癌抗原 199 水平、中性粒细胞与淋巴细胞比值、淋巴结转移和远处器官转移提示胰腺癌患者预后不良。早期发现、早期根治性手术和辅助化疗是改善这种致命疾病预后的必要措施。
