PDF(Pubmed)
Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
背景：将肠系膜上动脉（SMA）或肠系膜上静脉（SMV）与肿瘤边缘的最短距离与术前血清糖类抗原（CA）19-9和淋巴结比率（LNR）联合评价对胰头癌根治术后患者长期生存和肝转移的影响。
方法：本回顾性研究纳入2011年5月至2021年3月在哈尔滨医科大学附属肿瘤医院行胰十二指肠切除术的149例胰头癌患者。术前血清CA19-9程度和LNR联合SMA或SMV距离。评估了长期生存与术后肝转移之间的联合关联。
结果：基于术后肝转移或长期生存的受试者工作特征曲线，SMV距离的最佳截止值分别为3.1和0.7mm，分别,而SMA距离的最佳截断值为10.25mm。单因素模型将肝转移评分（p<0.001）确定为胰头癌术后肝转移的阴性因素。SMV距离（p=0.003），SMA距离（p<0.001），LNR评分（p<0.001），生存评分(p<0.001)与胰头癌后长期生存呈负相关。多变量模型突出显示了SMA距离(p<0.001)，生存评分（p=0.001），和LNR评分（p<0.001）是胰头癌长期生存的独立危险因素。
结论：肝转移评分可能是胰头癌患者术后肝转移的独立预测因素。生存率和LNR评分可能是胰头癌患者术后长期生存率的独立预测因子。然而,LNR评分似乎改善了长期生存率.
方法：本回顾性研究纳入2011年5月至2021年3月在哈尔滨医科大学附属肿瘤医院行胰十二指肠切除术的149例胰头癌患者。术前血清CA19-9程度和LNR联合SMA或SMV距离。评估了长期生存与术后肝转移之间的联合关联。
结果：基于术后肝转移或长期生存的受试者工作特征曲线，SMV距离的最佳截止值分别为3.1和0.7mm，分别,而SMA距离的最佳截断值为10.25mm。单因素模型将肝转移评分（p<0.001）确定为胰头癌术后肝转移的阴性因素。SMV距离（p=0.003），SMA距离（p<0.001），LNR评分（p<0.001），生存评分(p<0.001)与胰头癌后长期生存呈负相关。多变量模型突出显示了SMA距离(p<0.001)，生存评分（p=0.001），和LNR评分（p<0.001）是胰头癌长期生存的独立危险因素。
结论：肝转移评分可能是胰头癌患者术后肝转移的独立预测因素。生存率和LNR评分可能是胰头癌患者术后长期生存率的独立预测因子。然而,LNR评分似乎改善了长期生存率.
