Factors predicting survival in patients with locally advanced pancreatic cancer undergoing pancreatectomy with arterial resection

This study aimed to identify factors predicting cancer-specific survival in this patient population. A single-Institution prospective database was used. Pre-operative prognostic factors were identified and used to develop a prognostic score. Matching with pathologic parameters was used for internal validation. In a patient population with a median Ca 19.9 level of 19.8  U/mL(IQR: 7.1–77), cancer-specific survival was predicted by: metabolic deterioration of diabetes (OR = 0.22,p = 0.0012), platelet count (OR = 1.00;p = 0.0013), serum level of Ca 15.3 (OR = 1.01,p = 0.0018) and Ca 125 (OR = 1.02,p = 0.00000137), neutrophils-to-lymphocytes ratio (OR = 1.16;p = 0.00015), lymphocytes-to-monocytes ratio (OR = 0.88;p = 0.00233), platelets-to-lymphocytes ratio (OR = 0.99;p = 0.00118), and FOLFIRINOX neoadjuvant chemotherapy (OR = 0.57;p = 0.00144). A prognostic score was developed and three risk groups were identified. Harrell’s C-Index was 0.74. Median cancer-specific survival was 16.0 months (IQR: 12.3–28.2) for the high-risk group, 24.7 months (IQR: 17.6–33.4) for the intermediate-risk group, and 39.0 months (IQR: 22.7–NA) for the low-risk group (p = 0.0003). Matching the three risk groups against pathology parameters, N2 rate was 61.9, 42.1, and 23.8% (p = 0.04), median value of lymph-node ratio was 0.07 (IQR: 0.05–0.14), 0.04 (IQR:0.02–0.07), and 0.03 (IQR: 0.01–0.04) (p = 0.008), an...
Source: Updates in Surgery - Category: Surgery Source Type: research