Abstract
BackgroundRadical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head. Few studies have reported the clinical characteristics and treatment efficacies of patients undergoing radical pancreaticoduodenectomy for adenocarcinoma of the pancreatic head.MethodsA total of 177 pancreatic head cancer patients who underwent radical pancreaticoduodenectomy and were pathologically confirmed as having pancreatic ductal adenocarcinoma were screened in the West China Hospital of Sichuan University. The multivariate analysis results were implemented to construct a nomogram. The concordance index (c-index), the area under the curve (AUC) and calibration were utilized to evaluate the predictive performance of the nomogram.ResultsThe prognostic nutritional index (PNI), the lymph node ratio (LNR) and the American Joint Committee on Cancer (AJCC) staging served as independent prognostic factors and were used to construct the nomogram. The c-indexes of the nomogram were 0.799 (confidence interval (CI), 0.741–0.858) and 0.732 (0.657–0.807) in the primary set and validation set, respectively. The AUCs of the nomogram at 1 and 3 years were 0.832 and 0.783, which were superior to the AJCC staging values of 0.759 and 0.705, respectively.ConclusionsThe nomogram may be used to predict the prognosis of radical resection for adenocarcinoma of the pancreatic head. These findings may represent an effective model for the developing an optimal therapeutic schedule for malnourished patients who need early effective nutritional intervention and may promote the treatment efficacy of resectable adenocarcinoma of the pancreatic head.
Highlights
Radical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head
Patient characteristics The clinical characteristics of adenocarcinoma of the pancreatic head patients who underwent radical pancreaticoduodenectomy are shown in supplement 1
Analysis of risk factors for pancreatic head cancer The univariate analysis and the multivariate analysis showed that the prognostic nutritional index (PNI), lymph node ratio (LNR), and TNM 8th edition guidelines were associated with overall survival (OS) in the primary set (Table 1) and in the validation set (Table 2)
Summary
Radical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head. Few studies have reported the clinical characteristics and treatment efficacies of patients undergoing radical pancreaticoduodenectomy for adenocarcinoma of the pancreatic head. Some studies have disclosed clinical characteristics, such as resection margins, the PNI, the LNR, portal vein invasion and tumor differentiation, utilized to discriminate treatment outcomes in patients with pancreatic cancer [4,5,6,7,8]. Only a single indicator was used to assess postoperative survival for pancreatic cancer in those studies. For this reason, we discern some indicators that serve as prognostic markers that influence the postoperative outcome of pancreatic cancer
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