胰周脂肪侵犯对胰腺癌患者根治性切除术后预后的预测价值OA

Objective To investigate the prognostic value of peripancreatic fat invasion(PFI)in pancreatic cancer patients undergoing radical resection.Methods The clinical data of 174 pancreatic cancer patients who underwent radical pancreatic cancer resection in the First Hospital of Jiaxing from January 2015 to December 2022 were retrospectively analyzed.The Chi-square test or Fisher's exact test was used to analyze the correlation between PFI and clinicopathological characteristics.The Cox proportional hazards regression model was applied to identify the risk factors affecting the prognosis of pancreatic cancer patients and clarify the association between PFI and prognosis.The Kaplan-Meier method was used to plot the survival curves.The receiver operating characteristic(ROC)curve was adopted to evaluate the prognostic predictive efficacy of PFI.Results PFI was significantly correlated with neural invasion(χ2=5.842,P=0.016)in patients with pancreatic cancer.Multivariate Cox regression analysis showed that PFI was an independent risk factor affecting the overall survival(OS,HR=2.515,95%CI 1.755 to 3.604,P<0.001)and progression-free survival(PFS,HR=2.495,95%CI 1.694 to 3.676,P<0.001)of patients with paccreatic cancer.In patients received different postoperative adjuvant chemotherapy regimens with≥8 cycles,the OS time in PFI patients was shorter than that of non-PFI patients respectively(Gemcitabine:18.6 months vs 51.8 months,P<0.001;Gemcitabine+Capecitabine:18.4 months vs 80.8 months,P<0.001;Tegafur,Gimeracil+Oteracil:27.0 months vs 78.3 months,P=0.028)The area under the curve(AUC)of ROC for PFI predicting OS and PFS of pancreatic cancer patients undergoing surgical treatment at 1,3,and 5 years post-operation were 0.796,0.806,0.799 and 0.825,0.840,0.835,respectively.Conclusion PFI is an independent risk factor for the prognosis of pancreatic cancer patients,with reliable prognostic predictive efficacy.It can provide a key reference for the early clinical identification of high-risk patients,and neoadjuvant therapy may be considered as part of the individualized treatment strategy for such patients.