Prediction scores of postoperative liver metastasis and long‐term survival of pancreatic head cancer based on the distance between the mesenteric vessels and tumor, preoperative serum carbohydrate antigen 19‐9 level, and lymph node metastasis rate

Abstract

Background The shortest distance between the superior mesenteric artery (SMA) or superior mesenteric vein (SMV) and the tumor margin was combined with preoperative serum carbohydrate antigen (CA) 19‐9 and lymph node ratio (LNR) to evaluate joint effects on long‐term survival and liver metastasis in patients with pancreatic head cancer after radical surgery. Methods This retrospective study included 149 patients who underwent pancreaticoduodenectomy for pancreatic head cancer at Harbin Medical University Tumor Hospital from May 2011 to March 2021. The preoperative serum CA 19‐9 level and LNR were combined with the SMA or SMV distance. The joint association between long‐term survival and postoperative liver metastasis was evaluated. Results Based on the receiver operating characteristic curve of postoperative liver metastasis or long‐term survival, the optimal cut‐off values of SMV distance were 3.1 and 0.7 mm, respectively, whereas the optimal cut‐off value of SMA distance was 10.25 mm. The univariate model identified the liver metastasis score (p < 0.001) as a negative factor for postoperative liver metastasis of pancreatic head carcinoma. The SMV distance (p = 0.003), SMA distance (p < 0.001), LNR score (p < 0.001), and survival score (p < 0.001) were negatively correlated with long‐term survival after pancreatic head cancer. The multivariate model highlighted SMA distance (p < 0.001), survival score (p = 0.001), and LNR score (p < 0.001) as independent risk factors for long‐term survival in pancreatic head cancer. Conclusion Liver metastasis score may be an independent predictor of postoperative liver metastasis in patients with pancreatic head cancer. Survival and LNR scores may be independent predictors of long‐term postoperative survival in patients with pancreatic head cancer. However, the LNR score appears to improve long‐term survival.

Comparative analysis of surgical treatment of patients with locally advanced tumors right anatomical segment of pancreas

“…Основна мета хірургічного лікування -видалення пухлини у межах здорових тканин за рахунок досягнення негативних країв резекції, що в подальшому дає можливість отримати максимальний терапевтичний ефект від адьювантної хіміотерапії [2]. Однак, через пізню діагностику та відсутність специфічних діагностичних критеріїв для раннього виявлення даної патології, лише 10-20% пацієнтів піддаються радикальному оперативному лікуванню [3].…”