Analysis of prognostic and recurrence factors of pancreatic cancer received adjuvant chemotherapy

FANG Leping; XU Xiaoyan; JI Yu; HUANG Puwen

doi:10.3969/j.issn.1009-0460.2017.09.009

Abstract：Objective To investigate the prognostic and recurrence factors of pancreatic cancer patients treated with adjuvant chemotherapy,so as to improve the long-term survival of the patients with early detection of recurrence.Methods Seventy-seven pancreatic adenocarcinoma patients underwent resection with curative intent and received adjuvant chemotherapy from January 2008 to September 2015 were enrolled in this study.Results The median survival for all patients was 20.44 months.Univariate analysis identified differentiation,surgical margin status,tumor maximum diameter,intravascular cancer emboli,vascular invasion,lymph node metastasis,pre-operation CEA level,pre-operation neutrophil lymphocyte ratio (NLR) and postoperative chemotherapy were associated with prognosis.The multivariate analysis showed that lymph node metastasis,poorly differentiated,R1 resection and uncompleted adjuvant chemotherapy were negative prognosis factors.Univariate analysis of the maximum tumor size,T stage,vascular invasion and preoperative CEA levels was related to the recurrence of pancreatic cancer.Logistic regression analysis showed that invasion of blood vessels and elevated preoperative CEA levels were independent risk factors for recurrence of pancreatic cancer.Compared to patients without recurrence,patients with recurrence have shorter survival time.Conclusion Lymph node metastasis,low differentiation,R1 resection,and incomplete adjuvant chemotherapy are prognostic factors for pancreatic cancer patients receiving adjuvant chemotherapy.Pancreatic cancer patients with vascular invasion and preoperative CEA level were more likely to relapse,recurrence and survival time shorter,so these patients to early recurrence should pay attention to the assessment of the disease and the need for preoperative treatment.