Onji Makoto, Kozono Shingo, Nakai Asuka, Kakizoe Shinji, Naito Koichi
Department of Rehabilitation, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
Department of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
JMA J. 2025 Jul 15;8(3):893-902. doi: 10.31662/jmaj.2025-0105. Epub 2025 Jun 20.
Despite treatment advancements, pancreatic cancer continues to have the lowest 5-year survival rate and a high age-adjusted mortality. Limited physical and functional reserves often restrict therapeutic options. Although the 6-minute walk distance (6MWD) and the Charlson Comorbidity Index (CCI) are established prognostic markers, their combined prognostic utility remains unexplored. This study evaluated the prognostic value of a composite index (6MWD-CCI) in patients who underwent pancreatic resection.
This retrospective study included 85 patients with pancreatic cancer who underwent resection between July 2019 and September 2022. Preoperative 6MWD (<400 m) and CCI scores were used to classify patients into three 6MWD-CCI risk groups (low, middle, and high). Physical, nutritional, and frailty parameters were also assessed. Kaplan-Meier and Cox regression analyses were performed to evaluate survival outcomes, adjusting for confounders.
During a median follow-up of 802 days, 27 patients (31.8%) died. Low 6MWD, high CCI, and elevated 6MWD-CCI risk levels were significantly associated with reduced survival. The composite 6MWD-CCI demonstrated strong prognostic value, outperforming individual metrics even after adjustment for confounders.
The 6MWD-CCI is a practical and predictive tool for pancreatic cancer prognosis, integrating physical function and comorbidity burden to enhance risk stratification. Its incorporation into clinical workflows could improve preoperative planning. Validation through larger studies is recommended.
尽管治疗取得了进展，但胰腺癌的5年生存率仍然是所有癌症中最低的，且年龄调整死亡率很高。有限的身体和功能储备常常限制了治疗选择。虽然6分钟步行距离（6MWD）和查尔森合并症指数（CCI）是已确立的预后标志物，但其联合预后效用仍未得到探索。本研究评估了复合指数（6MWD-CCI）在接受胰腺切除术患者中的预后价值。
这项回顾性研究纳入了2019年7月至2022年9月期间接受切除术的85例胰腺癌患者。术前6MWD（<400 m）和CCI评分用于将患者分为三个6MWD-CCI风险组（低、中、高）。还评估了身体、营养和虚弱参数。进行了Kaplan-Meier和Cox回归分析以评估生存结果，并对混杂因素进行了调整。
在中位随访802天期间，27例患者（31.8%）死亡。低6MWD、高CCI和升高的6MWD-CCI风险水平与生存率降低显著相关。复合6MWD-CCI显示出很强的预后价值，即使在对混杂因素进行调整后，其表现也优于个体指标。
6MWD-CCI是一种用于胰腺癌预后的实用且具有预测性的工具，它整合了身体功能和合并症负担以加强风险分层。将其纳入临床工作流程可改善术前规划。建议通过更大规模的研究进行验证。
