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postoperative serum tumor markers-based nomogram predicting early recurrence for patients undergoing radical resections of pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3211-3223页

作者： Hang He Cai-Feng Zou Feng Yang Yang Di Chen Jin De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China

BACKGROUND Early recurrence(ER)is associated with dismal outcomes in patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC).Approaches for predicting ER will help clinicians in implementing individualized adjuvant *** serum tumor markers(STMs)are indicators of tumor progression and may improve current systems for predicting *** To establish an improved nomogram based on postoperative STMs to predict ER in *** We retrospectively enrolled 282 patients who underwent radical resection for PDAC at our institute between 2019 and *** and multivariate Cox regression analyses of variables with or without postoperative STMs,were performed to identify independent risk factors for ER.A nomogram was constructed based on the independent postoperative *** operating characteristic curve analysis was used to evaluate the area under the curve(AUC)of the *** analysis was performed using Kaplan-Meier survival plot and log-rank *** postoperative carbohydrate antigen 19-9 and carcinoembryonic antigen levels,preoperative carbohydrate antigen 125 levels,perineural invasion,and pTNM stage III were independent risk factors for ER in *** postoperative STMs-based nomogram(AUC:0.774,95%CI:0.713-0.835)had superior accuracy in predicting ER compared with the nomogram without postoperative STMs(AUC:0.688,95%CI:0.625-0.750)(P=0.016).Patients with a recurrence nomogram score(RNS)>1.56 were at high risk for ER,and had significantly poorer recurrence-free survival[median:3.08 months,interquartile range(IQR):1.80-8.15]than those with RNS≤1.56(14.00 months,IQR:6.67-24.80),Ppostoperative STMs-based nomogram improves the predictive accuracy of ER in PDAC,stratifies the risk of ER,and identifies patients at high risk of ER for tailored adjuvant therapies.

关键词： Nomogram postoperative serum tumor markers Early recurrence Predicting accuracy Adjuvant therapy Pancreatic ductal adenocarcinoma

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