Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study
Abstract Background The pancreatic index (PI) is a useful preoperative imaging predictor for pancreatic ductal adenocarcinoma (PDAC). In this retrospective study, we determined the predictive effect of PI to distinguish patients of pancreatic body/tail cancer (PBTC) with vascular involvement who can...
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| Language: | English |
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Wiley
2023-12-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6687 |
| _version_ | 1797387135695716352 |
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| author | Lihan Qian Jingfeng Li Yanjun Sun Weimin Chai Xiaxing Deng Weishen Wang Baiyong Shen |
| author_facet | Lihan Qian Jingfeng Li Yanjun Sun Weimin Chai Xiaxing Deng Weishen Wang Baiyong Shen |
| author_sort | Lihan Qian |
| collection | DOAJ |
| description | Abstract Background The pancreatic index (PI) is a useful preoperative imaging predictor for pancreatic ductal adenocarcinoma (PDAC). In this retrospective study, we determined the predictive effect of PI to distinguish patients of pancreatic body/tail cancer (PBTC) with vascular involvement who can benefit from upfront surgery. Method All patients who received distal pancreatectomy for PDAC from 2016 to 2020 at the Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were considered for the study. A total of 429 patients with PBTC were assessed in relation to the value of PI. Fifty‐five patients were eventually included and divided into low PI group and 29 patients in the normal PI group. Results The median overall survival (mOS) was significantly shorter in the low PI group (13.1 vs. 30.0 months, p = 0.002) in this study, and PI ≥ 0.78 (OR = 0.552, 95% CI: 0.301–0.904, p = 0.020) was an independent influencing factor confirmed by multivariate analysis. Subgroup analysis showed that PI was an independent prognostic factor for LA‐PBTC (OR = 0.272, 95% CI: 0.077–0.969, p = 0.045). As for BR PBTC, PI (OR = 0.519, 95% CI: 0.285–0.947, p = 0.033) combined with carbohydrate antigen 125 (CA125) (OR = 2.806, 95% CI: 1.206–6.526, p = 0.017) and chemotherapy (OR = 0.327, 95% CI: 0.140–0.763, p = 0.010) were independent factors. Conclusion This study suggests that the PI can be used as a predictive factor to optimize the surgical indication for PBTC with vascular involvement. Preoperative patients with normal PI and CA125 can achieve a long‐term prognosis comparable to that of resectable PBTC patients. |
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| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T22:19:32Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-a586ffff6a114397b2e236f8c75421722023-12-18T14:43:07ZengWileyCancer Medicine2045-76342023-12-011223211992120810.1002/cam4.6687Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective studyLihan Qian0Jingfeng Li1Yanjun Sun2Weimin Chai3Xiaxing Deng4Weishen Wang5Baiyong Shen6Department of General Surgery Pancreatic Disease Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of General Surgery Pancreatic Disease Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Cardiovascular Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Radiology Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of General Surgery Pancreatic Disease Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of General Surgery Pancreatic Disease Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of General Surgery Pancreatic Disease Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaAbstract Background The pancreatic index (PI) is a useful preoperative imaging predictor for pancreatic ductal adenocarcinoma (PDAC). In this retrospective study, we determined the predictive effect of PI to distinguish patients of pancreatic body/tail cancer (PBTC) with vascular involvement who can benefit from upfront surgery. Method All patients who received distal pancreatectomy for PDAC from 2016 to 2020 at the Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were considered for the study. A total of 429 patients with PBTC were assessed in relation to the value of PI. Fifty‐five patients were eventually included and divided into low PI group and 29 patients in the normal PI group. Results The median overall survival (mOS) was significantly shorter in the low PI group (13.1 vs. 30.0 months, p = 0.002) in this study, and PI ≥ 0.78 (OR = 0.552, 95% CI: 0.301–0.904, p = 0.020) was an independent influencing factor confirmed by multivariate analysis. Subgroup analysis showed that PI was an independent prognostic factor for LA‐PBTC (OR = 0.272, 95% CI: 0.077–0.969, p = 0.045). As for BR PBTC, PI (OR = 0.519, 95% CI: 0.285–0.947, p = 0.033) combined with carbohydrate antigen 125 (CA125) (OR = 2.806, 95% CI: 1.206–6.526, p = 0.017) and chemotherapy (OR = 0.327, 95% CI: 0.140–0.763, p = 0.010) were independent factors. Conclusion This study suggests that the PI can be used as a predictive factor to optimize the surgical indication for PBTC with vascular involvement. Preoperative patients with normal PI and CA125 can achieve a long‐term prognosis comparable to that of resectable PBTC patients.https://doi.org/10.1002/cam4.6687borderline resectablelocally advancedpancreatic body/tail cancerpancreatic ductal adenocarcinomapancreatic index |
| spellingShingle | Lihan Qian Jingfeng Li Yanjun Sun Weimin Chai Xiaxing Deng Weishen Wang Baiyong Shen Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study Cancer Medicine borderline resectable locally advanced pancreatic body/tail cancer pancreatic ductal adenocarcinoma pancreatic index |
| title | Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study |
| title_full | Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study |
| title_fullStr | Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study |
| title_full_unstemmed | Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study |
| title_short | Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement—A retrospective study |
| title_sort | pancreatic index a prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement a retrospective study |
| topic | borderline resectable locally advanced pancreatic body/tail cancer pancreatic ductal adenocarcinoma pancreatic index |
| url | https://doi.org/10.1002/cam4.6687 |
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