Department of Hepatobiliary and Pancreatic Surgery, Tongliao City Hospital, Tongliao, China.
Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Medicine (Baltimore). 2024 Mar 8;103(10):e37440. doi: 10.1097/MD.0000000000037440.
Pancreatic cancer is a highly aggressive malignancy that is characterized by early metastasis, high recurrence, and therapy resistance. Early recurrence after surgery is one of the important reasons affecting the prognosis of pancreatic cancer. This study aimed to establish an accurate preoperative nomogram model for predicting early recurrence (ER) for resectable pancreatic adenocarcinoma. We retrospectively analyzed patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma between January 2011 and December 2020. The training set consisted of 604 patients, while the validation set included 222 patients. Survival was estimated using Kaplan-Meier curves. The factors influencing early recurrence of resectable pancreatic cancer after surgery were investigated, then the predictive model for early recurrence was established, and subsequently the predictive model was validated based on the data of the validation group. The preoperative risk factors for ER included a Charlson age-comorbidity index ≥ 4 (odds ratio [OR]: 0.628), tumor size > 3.0 cm on computed tomography (OR: 0.628), presence of clinical symptoms (OR: 0.515), carbohydrate antigen 19-9 > 181.3 U/mL (OR 0.396), and carcinoembryonic antigen > 6.01 (OR: 0.440). The area under the curve (AUC) of the predictive model in the training group was 0.711 (95% confidence interval: 0.669-0.752), while it reached 0.730 (95% CI: 0.663-0.797) in the validation group. The predictive model may enable the prediction of the risk of postoperative ER in patients with resectable pancreatic ductal adenocarcinoma, thereby optimizing preoperative decision-making for effective treatment.
胰腺癌是一种侵袭性很强的恶性肿瘤，其特征是早期转移、高复发和治疗耐药。手术后早期复发是影响胰腺癌预后的重要原因之一。本研究旨在建立一种准确的术前列线图模型，以预测可切除胰腺导管腺癌的早期复发（ER）。我们回顾性分析了 2011 年 1 月至 2020 年 12 月期间接受胰腺切除术治疗胰腺导管腺癌的患者。训练集包含 604 例患者，验证集包含 222 例患者。使用 Kaplan-Meier 曲线估计生存情况。分析影响可切除胰腺癌手术后早期复发的因素，建立早期复发预测模型，然后根据验证组的数据验证预测模型。ER 的术前危险因素包括Charlson 合并症指数≥4（比值比 [OR]：0.628）、CT 上肿瘤大小>3.0cm（OR：0.628）、存在临床症状（OR：0.515）、CA19-9>181.3 U/mL（OR 0.396）和癌胚抗原>6.01（OR：0.440）。训练组预测模型的曲线下面积（AUC）为 0.711（95%置信区间：0.669-0.752），验证组为 0.730（95%置信区间：0.663-0.797）。该预测模型可预测可切除胰腺导管腺癌患者术后 ER 的风险，从而优化术前决策，进行有效治疗。
