| Title | Predicting early recurrence for resected pancreatic ductal adenocarcinoma: a multicenter retrospective study in China |
| Authors | Liu, Weikang Tang, Bingjun Wang, Feng Qu, Chang Hu, Hao Zhuang, Yan Gao, Hongqiao Xie, Xuehai Tian, Xiaodong Yang, Yinmo |
| Affiliation | Peking Univ, Hosp 1, Dept Gen Surg, 8 Xishiku St, Beijing 100034, Peoples R China Peking Univ, Dept Endoscopy Ctr, Hosp 1, Beijing 100034, Peoples R China Aerosp Ctr Hosp, Dept Hepatobiliary Surg, Beijing 100034, Peoples R China |
| Keywords | TUMOR SIZE CANCER MESOTHELIN NOMOGRAM CA19-9 CA125 |
| Issue Date | 2021 |
| Publisher | AMERICAN JOURNAL OF CANCER RESEARCH |
| Abstract | A precise classification of early recurrence (ER) after radical surgery of pancreatic ductal adenocarcinoma (PDAC) has not been standardized. We aim to develop an optimal cut-off based on scientific evidence to distinguish early and late recurrence (LR) for PDAC after radical surgery and develop a predictive model for ER of PDAC. The best threshold for recurrence-free survival (RFS) was assessed with a minimum P-value method, and patients were categorized into ER and LR groups. We used a logistic regression model to assess potential risk factors for ER and develop a predictive model for ER risk. The best threshold between high-risk and intermediate-high-risk groups was identified by using the receiver operating characteristic curve. Among 3,279 patients included, 1,234 (37.6%) experienced ER. The RFS of 9 months is the optimal threshold to distinguish ER and LR. Univariable and multivariable analysis identified four preoperative risk factors for ER, including larger tumor maximal diameter on computed tomography (CT), enlarged lymph nodes on CT, carbohydrate antigen (CA) 125 > 35 U/ml, and CA19-9 > 235 U/ml. The concordance index (C-index) for the predictive model in the training cohort and the validation cohort was 0.651 (95% confidence interval (CI): 0.624-0.678), and 0.636 (95% CI: 0.593-0.679), respectively, showing promising predictive ability. The high-risk group had a score above 203, and the corresponding risk of ER for this group was 56.7%. An RFS of 9 months is the best threshold to distinguish ER and LR. The model can accurately predict the risk of ER in PDAC after radical resection, and risk grouping can predict the patients who could benefit from upfront surgery. |
| URI | http://hdl.handle.net/20.500.11897/622728 |
| ISSN | 2156-6976 |
| Indexed | SCI(E) |
| Appears in Collections: | 第一医院 |
