Analysis of prognostic factors in patients with pancreatic body and tail carcinoma / 中华胰腺病杂志

ABSTRACT

Objective:To investigate the prognostic factors of patients with pancreatic body and tail carcinoma.Methods:The clinical data of 64 patients with pancreatic body and tail carcinoma who underwent surgical resection or endoscopic ultrasound biopsy and were pathologically confirmed in the Second Affiliated Hospital of Jiaxing University from January 2013 to March 2020 were retrospectively analyzed. Age, gender, diabetes mellitus, serum CEA and CA19-9 levels at initial diagnosis, tumor site, maximum tumor diameter, TNM stage and treatment method were collected. Kaplan-Meier method was used to draw survival curve, and Log-rank test was used to analyze survival rate. Univariate and multivariate Cox proportional risk regression models were used for prognostic analysis.Results:Among the 64 patients, 24 patients were complicated with diabetes; serum CEA level was increased in 36 cases, and serum CA19-9 level was increased in 46 cases; 8 cases were in TNM stage ⅠA, 4 cases were in ⅠB stage, 4 cases were ⅡA stage, 4 cases were in ⅡB stage, 8 cases were in Ⅲ stage, and 36 cases were in Ⅳ stage. Symptomatic treatment was performed in 18 cases, chemotherapy combined with immunotherapy were in 18 cases, and surgical comprehensive therapy (surgery combined with chemotherapy and immunotherapy) were in 26 cases. Univariate analysis showed that diabetes mellitus, serum CEA and CA19-9 levels, TNM stage and treatment mode were related factors affecting the prognosis of patients with pancreatic body and tail carcinoma (all P value <0.05). Multivariate analysis indicated that TNM stage ( HR=2.536) and surgical comprehensive therapy ( HR=0.285) were the independent factors affecting the prognosis of patients with pancreatic body and tail carcinoma ( P<0.05). Median survival was 25 months (95% CI 21.416-28.584) for patients with TNM stage Ⅲ+ Ⅳ pancreatic body and tail carcinoma treated with surgical comprehensive therapy, 11 months (95% CI 7.246-14.754) for patients treated with chemotherapy combined with immunotherapy, and 6 months (95% CI 3.819-8.181) for patients treated with symptomatic treatment; the median survival time of patients with surgical comprehensive therapy was significantly longer than that of patients with chemotherapy combined with immunotherapy and symptomatic treatment, and the difference was statistically significant ( P<0.05). Conclusions:TNM stage and surgical comprehensive therapy were the prognostic factors affecting the prognosis of patients with pancreatic body and tail carcinoma, and surgical comprehensive therapy may be the best choice for long-term survival of patients.