Analysis Of Survival And Prognostic Factors Of Patients With Pancreatic Cancer After Radical Surgery

Objective:To investigate the clinicopathologic features,survival status and prognostic factors of patients with pancreatic cancer after radical resection.To understand the overall diagnosis and treatment effect of pancreatic cancer in our center during past one decades and provide objective data support and ideas for selection and optimization of future treatment methods,improvement of life quality and extension of overall survival.Method:The clinicopathologic data of 218 patients with pancreatic cancer who were admitted to the Department of Pancreatic Surgery of our hospital from January 1,2008 to December 31,2019 were collected,followed up,survival analysis was conducted by Kaplan-Meier method,and survival differences among variable subgroups were determined by Log-rank test.Independent prognostic risk factors were assessed by Cox proportional hazard model.Results:The median overall survival(MOS)of the 218patients was 18.5(95%CI:15.7-21.3)months.The 1-year,3-year and 5-year survival rates were 68.3%,24.8%and 9.8%,respectively.Univariate analysis showed that there were statistically significant differences in overall survival in age,BMI,weight loss,degree of tumor pathological differentiation,tumor size,TNM stage,peripheral lymphatic metastasis,peripheral nerve,vascular invasion,postoperative adjuvant chemotherapy,preoperative CA19-9 and CA125 levels(P<0.05).Multivariate analysis showed that patient`s age>64 years,BMI>24kg/m2,the degree of pathological differentiation of tumor was high-medium/medium,and preoperative CA125 level>13.5U/ml were independent risk factors for 5 years OS.No adjuvant chemotherapy was an independent risk factors for 3 years OS,the efficacy of adjuvant chemotherapy was obvious in the last few years after surgery,but with the extension of postoperative survival,the efficacy of adjuvant chemotherapy decreased.Conclusions:Factors such as advanced age,overweight,low degree of pathological differentiation of tumor,larger size of tumor,higher TNM stage,peripheral lymphatic metastasis,peripheral nerve and vascular invasion,no postoperative adjuvant chemotherapy,and high preoperative CA19-9 and CA125 levels shorten the overall postoperative survival time or increase the risk of death in pancreatic cancer patients.In addition,patients with age>64 years old,BMI>24kg/m~2,high-medium/medium differentiated,medium-low/low differentiated tumors,preoperative CA125 level>13.5U/ml and no adjuvant chemotherapy had poor long-term prognosis and shorter survival time.