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. 2024 Dec;48(12):3001-3013.
doi: 10.1002/wjs.12397. Epub 2024 Nov 14.

Clinicopathological predictive factors in long-term survivors who underwent surgery for pancreatic ductal adenocarcinoma: A single-center propensity score matched analysis

Carlo Ingaldi  1   2 , Vincenzo D'Ambra  1   2 , Claudio Ricci  1   2 , Laura Alberici  1   2 , Margherita Minghetti  1   2 , Davide Grego  1   2 , Virginia Cavallaro  1   2 , Riccardo Casadei  1   2
Affiliations

Clinicopathological predictive factors in long-term survivors who underwent surgery for pancreatic ductal adenocarcinoma: A single-center propensity score matched analysis

Carlo Ingaldi et al. World J Surg. 2024 Dec.

Abstract

Background: Long-term survivors (LTSs) after pancreatic resection of pancreatic ductal adenocarcinoma (PDAC) represent a particular subgroup of patients that remains poorly understood. The primary endpoint was to identify clinicopathological factors associated with LTSs after pancreatic resection for PDAC.

Methods: This was a retrospective study of patients who had undergone pancreatic resection for PDAC. Long survival was defined as a patient who survived at least 60 months. Patients were divided in two groups: LTS and short-term survivor (STS). The two groups were compared regarding epidemiological, clinical, and pathological data. Propensity score matching (PSM) was used to reduce selection bias with a 1:2 ratio. Multivariable analysis of significative predictive factors before and after PSM was done.

Results: Three hundred and thirty-three patients were enrolled: 46 (13.8%) in the LTS group and 287 (86.2%) in the STS group. Using PSM, 138 patients were analyzed: 46 in the LTS group and 92 in the STS group. At the multivariate analysis of significative predictive factor after PSM, adjuvant chemotherapy, well-differentiated tumors (G1), and R0 status were related to long-term survival (p = 0.052, 0.010 and p = 0.019, respectively). Kaplan-Meier survival curves confirmed these data. Additionally, Kaplan-Meier survival curves showed that pathological stage I was a favorable factor with respect to stage II, III, and IV.

Conclusions: Long-term survival is possible after pancreatic cancer resection, even if in a small percentage. Significant predictors of long-term survival are administration of adjuvant chemotherapy, American Join Committee on Cancer stage I, well-differentiated tumor (G1), and R0 resection.

Keywords: long‐term survival; pancreatectomy; pancreatic cancer; pancreatic ductal adenocarcinoma; predictive factors.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the selection process. LTS, long‐term survivor; PDAC, pancreatic ductal adenocarcinoma; PSM, propensity score matching; STS, short‐term survivor.
FIGURE 2
FIGURE 2
Survival analysis of all patients (n = 333) included in the study before PSM analysis: (A) survival analysis of all patients and regarding, (B) AJCC pathological stage, (C) R status, and (D) grading. AJCC, American Join Committee on Cancer.
FIGURE 3
FIGURE 3
Survival analysis of patients included in the study after PSM analysis: (A) survival analysis regarding R status, (B) AJCC pathological stage, (C) adjuvant chemotherapy, and (D) grading. AJCC, American Join Committee on Cancer.
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