Liu Xiao-Hui, Xie Jing-Hong, Zhu Xi-Song, Liu Li-Heng
Department of Radiology, Wenzhou Medical University Affiliated Quzhou Hospital (Quzhou People's Hospital), Quzhou 324000, Zhejiang Province, China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200000, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):107804. doi: 10.4240/wjgs.v17.i7.107804.
The computed tomography (CT)-based preoperative risk score was developed to predict recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC) in South Korea. However, whether it performs well in other countries remains unknown.
To externally validate the CT-based preoperative risk score for PDAC in a country outside South Korea.
Consecutive patients with PDAC who underwent upfront surgery from January 2016 to December 2019 at our institute in a country outside South Korea were retrospectively included. The study utilized the CT-based risk scoring system, which incorporates tumor size, portal venous phase density, tumor necrosis, peripancreatic infiltration, and suspicious metastatic lymph nodes. Patients were categorized into prognosis groups based on their risk score, as good (risk score < 2), moderate (risk score 2-4), and poor (risk score ≥ 5).
A total of 283 patients were evaluated, comprising 170 males and 113 females, with an average age of 63.52 ± 8.71 years. Follow-up was conducted until May 2023, and 76% of patients experienced tumor recurrence with median recurrence-free survival (RFS) of 29.1 ± 1.9 months. According to the evaluation results of Reader 1, the recurrence rates were 39.0% in the good prognosis group, 82.1% in the moderate group, and 84.5% in the poor group. In comparison, Reader 2 reported recurrence rates of 50.0%, 79.5%, and 88.9%, respectively, across the same prognostic categories. The study validated the effectiveness of the risk scoring system, demonstrating better RFS in the good prognosis group.
This research validated that the CT-based preoperative risk scoring system can effectively predict RFS in patients with PDAC, suggesting that it may be valuable in diverse populations.
基于计算机断层扫描（CT）的术前风险评分旨在预测韩国可切除性胰腺导管腺癌（PDAC）患者 upfront 手术后的复发情况。然而，该评分在其他国家是否有效尚不清楚。
在韩国以外的国家对基于 CT 的 PDAC 术前风险评分进行外部验证。
回顾性纳入 2016 年 1 月至 2019 年 12 月在韩国以外某国我们研究所接受 upfront 手术的连续 PDAC 患者。该研究采用基于 CT 的风险评分系统，该系统纳入了肿瘤大小、门静脉期密度、肿瘤坏死、胰腺周围浸润和可疑转移性淋巴结。患者根据风险评分分为预后组，即良好（风险评分<2）、中等（风险评分 2 - 4）和差（风险评分≥5）。
共评估了 283 例患者，其中男性 170 例，女性 113 例，平均年龄 63.52±8.71 岁。随访至 2023 年 5 月，76%的患者出现肿瘤复发，无复发生存期（RFS）中位数为 29.1±1.9 个月。根据读者 1 的评估结果，良好预后组的复发率为 39.0%，中等组为 82.1%，差组为 84.5%。相比之下，读者 2 报告相同预后类别的复发率分别为 50.0%、79.5%和 88.9%。该研究验证了风险评分系统的有效性，表明良好预后组的 RFS 更好。
本研究验证了基于 CT 的术前风险评分系统可有效预测 PDAC 患者的 RFS，表明其在不同人群中可能具有价值。
