Multivariate Analysis Of Prognosis In Patients With Pancreatic Cancer

Objective:Pancreatic cancer is a highly malignant digestive system tumor that is mostly advanced at the time of discovery and has lost its chance of surgery.The 2018 U.S.cancer data showed that the 5-year survival rate of pancreatic cancer increased slightly,only 3%.The importance of early diagnosis of pancreatic cancer and intervention of prognostic factors is the key to improve prognosis.To explore the factors that multivariate influence the prognosis of pancreatic cancer.Methods:We conducted a retrospective cohort study using electronic medical record database from the First Hospital of Jilin University from January 2014 to December 2016.We chose 493 newly diagnosed pancreatic cancer patients,confirmed by pathological specimens or radiology.Clinical information,such as gender,Age,history of smoking,drinking,hypertension,coronary heart disease and diabetes,TNM staging,pathological type,differentiation,diabetes complications,treatment options,postoperative complications,serum tumor markers and serum albumin,were collected.And the total score of PG-SGA in the nutrition questionnaire was collected.461 patients were followed up.The primary outcome was overall survival,while the second outcome is postoperative survival.The difference of intragroup measured data complying with the normal distribution was performed using the t-test.Count data and ordinal data was performed using chi-square test.Kaplan-Meier method was used to calculate survival rate.The survival curve was compared with Log-rank test.A multivariate analysis was performed for each prognostic factor using the COX proportional hazards model.P < 0.05 was considered to be statistically significant.Results:1.The median overall survival time of 493 patients was 10 months.The 1-year,2-year,and 3-year cumulative survival rates were 41.5%,20.6%,and 9.9%,respectively.Univariate survival analysis revealed that TNM staging(P <0.001),treatment regimen(P<0.001),CA125(P<0.001),the level of serum albumin(P=0.014)were significantly correlated with prognosis of pancreatic cancer.COX proportional hazards regression model showed that TNM staging(P=0.038),CA125(P=0.003)and the level of serum albumin(P=0.037)were Independent factors affecting the median OS.The prognosis of patients with ? staging,elevated levels of serum albumin group and elevated levels of CA125 group was poor.2.Univariate analysis of patients with stage ?-? pancreatic cancer revealed that treatment regimen(P<0.001)and CA125(P<0.001)were independent prognostic factors.The patients who did not receive operational treatment and elevated levels of CA125 had a poor prognosis.3.73 patients with pancreatic cancer underwent surgical resection.The median postoperative survival time was 28 months.The 1-year,2-year,and 3-year cumulative survival rates were 74.4%,47.7%,and 21.4%,respectively.Univariate analysis revealed that TNM staging(P=0.032),pathological type(P=0.012),hypoglycemia(P =0.040),CA125(P<0.001),were significantly correlated with prognosis of pancreatic cancer.The COX proportional hazards regression model showed that TNM staging(P=0.008),pathological type(P=0.045)and CA125(P=0.017),were independent prognostic factors after resection of pancreatic cancer.The prognosis of patients with advanced staging,non-ductal adenocarcinoma and elevated levels of CA125 group was poor.Conclusions:1.Treatment regimen and CA125 are independent prognostic factors for the overall survival of patients with pancreatic cancer.2.Treatment regimen,CA125 is an independent f prognostic factors for the overall survival of patients with stage ?-? pancreatic cancer.3.TNM staging,pathological type and CA125 are independent prognostic factors in patients with pancreatic cancer after resection.