Analysis Of Related Factors Influencing The Prognosis Of Patients After Pancreatic Head Carcinoma Resection

Objective To analyze the factors influencing prognosis and provide clinical guidance for the evaluation of postoperative survival of patients after pancreatic head carcinoma resection.Methods Retrospective analysis of clinical cases and follow-up data of patients after pancreatic carcinoma resection from December 2011 to December 2017 in Ningxia Hui Autonomous Region People's Hospital and Ningxia Medical University Hospital.We calculated the survival of these patients by Kaplan-Meier method,and Univariate analysis of these indicators by Log-rank test included age,gender,preoperative Body mass index(BMI),diabetes,preoperative hyperglycemia,postoperative hyperglycemia,preoperative Carbohydrateantigen199(CA199)level,preoperative Carcinoembryonicantigen(CEA)level,preoperative Neutrophiltolymphocyteratio(NLR),tumor size,degree of tumor differentiation,surgical margin,lymph node metastasis,number of lymph nodes,number of metastatic lymph nodes,lymph node ratio(LNR),vascular invasion,nerve invasion.We also introduced the Cox proportional risk model to perform multivariate analysis on indicators with statistically significant differences in univariate analysis and identify independent risk factors that affect the prognosis of patients after pancreatic head carcinoma resection.Results We selected 55 clinical cases and follow-up data to analyze.The 6-month,1-year and 2-year survival rates of these patients were 76%,52% and 20%.The median survival time was 13 months.We also used Kaplan Meier method to compare the survival rates among groups.The results showed that there were no significant differences(P>0.05)inage,gender,preoperative BMI,diabetes,preoperative hyperglycemia,postoperative hyperglycemia,preoperative CEA level,preoperative NLR,tumor size,degree of tumor differentiation,total number of lymph nodes,number of metastatic lymph nodes,LNR and vascular invasion.The median survival of patients with preoperative CA199 level<37 U/ml and preoperative CA199 level?37 U/ml was 20 months and 8 months.The median survival of patients with negative surgical margin and positive surgical margin were 14 months and 8months.The median survival of patients without lymph node metastasis and lymph node metastasis was 14 months and 5 months.The median survival of the patients without nerve invasion and those with nerve invasion was 14 months and 5 months,respectively.The difference in these results was statistically significant(P <0.05).We also introduced the indexes with statistical significance of univariate analysis results into Cox proportional risk model for multivariate analysis and found that there was statistical significance in preoperative CA199 level,surgical margins,lymph node metastasis and nerve invasion(P < 0.05).Conclusion We found that factors influencing the prognosis of patients after pancreatic head carcinoma resection included preoperative CA199 levels,surgical margins,lymph node metastasis,and nerve invasion.We also found that preoperative CA199 levels,surgical margins,lymph node metastasis,and nerve invasion were independent risk factors for the patients after pancreatic head carcinoma resection.