Analysis Of Prognostic Factors In Radical Resection Of Pancreatic Cancer

Objective:The clinical data of 70 patients undergoing radical resection of pancreatic cancer were retrospectively analyzed to explore the factors related to postoperative survival of the patients.Methods:Retrospective analysis was performed on the clinical case data and follow-up survival of patients who underwent radical resection of pancreatic cancer in the Third Affiliated Hospital of Kunming Medical University from November 2013 to October 2020.Preoperative data,intraoperative indicators,postoperative pathology-related indicators,postoperative complications,postoperative chemotherapy and other clinicopathological factors were collected.The survival of the patients was obtained through telephone follow-up and medical records in the hospital.Univariate analysis was performed by Kaplan-Meier method and Log-rank test,and independent prognostic factors were analyzed by Cox proportional risk regression model.Results:1.The median OS after radical resection was 12.90 months,and the overall survival rates at 6,12 and 24 months were 87.3%,51.8%and 13.6%,respectively.The median DFS was 6.46 months,and the disease-free survival rates at 6,12 and 24 months were 57.9%,24.6%and 6.8%,respectively.2.The median OS was 21.65 months in patients with physical examination and 11.26 months in patients with symptoms(P=0.031).The median DFS was 17.3 months for those who had physical examination and 6.10 months for those with symptoms(P=0.009).3.The median OS of CA199≤500 U/mL group was 13.76 months,The median DFS of CA199<500 U/mL group was 8.76 months(P=0.006);The median DFS of CA199≤500 U/mL group was 8.66 months,The median DFS of CA199<500 U/mL group was 6.26 months(P=0.023).4.The median OS was 23.20 months in highly differentiated patients,which was longer than 13.76 months and 7.50 months in moderate and poorly differentiated patients(P=0.002).The median DFS was 17.00 months in highly differentiated patients,which was longer than 9.16 months and 4.90 months in moderate and poorly differentiated patients(P=0.005).5.The median OS and DFS in the vascular thrombus group were lower than those in the vascular thrombus group(6.51 months vs 15.10 months;3.51 months vs8.40 months)(P=0.000).6.The median survival time of No group,Ni group and N2 group was 15.40 months,10.63 months and 6.00 months,respectively(P=0.001);The median progression-free survival time of No group,Ni group and N2 group was 8.66 months,5.78 months and 4.90 months,respectively(P=0.023).7.The OS of stage I and II was 15.40 months and 13.76 months respectively,which were significantly higher than 6.00 months and 6.90 months in stage III and IV(P=0.000);In terms of DFS,the duration of 8.66 months and 10.63 months in stage I and II were also significantly higher than that of 4.90 months and 1.93 months in stage III and IV(P=0.000).8.The median OS was 11.43 months in the transfusion group and 15.50 months in the non-transfusion group(P=0.091).The median DFS was 6.20 months in the transfusion group and 10.63 months in the non-transfusion group(P=0.046).9.The median OS of patients receiving postoperative chemotherapy was 15.40 months longer than 8.53 months of those without chemotherapy(P=0.001),the median DFS of patients receiving postoperative chemotherapy was 8.40 months longer than that of those without chemotherapy(P=0.003).10.In multivariate analysis,the preoperative CA199 level,the number of lymph node metastasis,the presence or absence of vascular cancer emboli,and the degree of differentiation were independently associated with the survival time of patients after radical resection of pancreatic cancer(P<0.005).Preoperative CA199 level,presence or absence of vascular cancer emboli,degree of differentiation,and TNM stage were independently correlated with progression free after radical resection of pancreatic cancer(P<0.005).Conclusion:1.High preoperative CA199 level,high number of lymph node metastases,presence of vascular emboli,and poor differentiation were independent risk factors for survival time of patients undergoing radical resection of pancreatic cancer.2.High preoperative CA199 level,presence of vascular emboli,poor differentiation,and late tumor stage were independent risk factors for progression-free survival in patients undergoing radical resection of pancreatic cancer.