Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths among individuals over the age of 50. It is characterized by exceptional aggressiveness and is often diagnosed at an advanced stage, highlighting the importance of assessing prognostic factors. The deep awareness of these factors may help in better prevention and treatment planning, eventually improving the outcomes. Favorable prognostic factors include female gender, low tumor stage, ECOG (Eastern Cooperative Oncology Group) 0–1, lowest ASI (Activated Stroma Index), low-grade tumor budding, age below 40, adequate nutrition, and absence of distant metastases. Conversely, unfavorable prognostic factors include the presence of distant metastases and metastases into lymph nodes, high tumor stage, LVI (lymphovascular invasion), PNI (perineural invasion), tumor size above 3 cm, invasion into vessels, higher G grade, higher ASI, high-grade tumor budding, more than 1 CTC (circulating tumor cells) in the bloodstream, ECOG 3–4, age above 40, Black ethnicity, malnutrition, and sarcopenia. This review discusses the prognostic factors of PDAC related to tumor characteristics and the patient’s clinical issues. The aim of this review is to synthesize current evidence on prognostic determinants in PDAC, with particular attention to both tumor characteristics and patient-specific clinical features. To achieve this, a comprehensive literature review was performed using PubMed, BrowZine Library, Cochrane Library, SpringerLink, Wiley Online Library, BMJ Journals, and Google Scholar. Relevant studies addressing established and emerging prognostic markers were critically analyzed to provide an updated overview of factors that may influence survival and treatment outcomes. By integrating available data, this review seeks not only to summarize classical prognostic variables but also to highlight novel and underrecognized markers that may hold future clinical relevance. Such an approach may contribute to the refinement of prognostic models, support more accurate patient counseling, and ultimately aid in the optimization of therapeutic strategies for individuals affected by PDAC.
胰腺导管腺癌（PDAC）是50岁以上人群癌症相关死亡的第三大原因。其特点是侵袭性极强，通常在晚期才被诊断，这凸显了评估预后因素的重要性。深入了解这些因素可能有助于更好地进行预防和治疗规划，最终改善预后。有利的预后因素包括女性、低肿瘤分期、ECOG（东部肿瘤协作组）评分0-1、最低的ASI（活化基质指数）、低级别肿瘤出芽、年龄低于40岁、营养状况良好以及无远处转移。相反，不利的预后因素包括存在远处转移和淋巴结转移、高肿瘤分期、淋巴血管侵犯（LVI）、神经周围侵犯（PNI）、肿瘤大小超过3厘米、血管侵犯、较高的G分级、较高的ASI、高级别肿瘤出芽、血液中循环肿瘤细胞（CTC）超过1个、ECOG评分3-4、年龄超过40岁、黑人种族、营养不良和肌肉减少症。本综述讨论了与肿瘤特征和患者临床问题相关的PDAC预后因素。本综述旨在综合当前关于PDAC预后决定因素的证据，特别关注肿瘤特征和患者特异性临床特征。为此，我们使用PubMed、BrowZine Library、Cochrane Library、SpringerLink、Wiley Online Library、BMJ Journals和Google Scholar进行了全面的文献综述。对涉及已确立和新兴预后标志物的相关研究进行了批判性分析，以提供可能影响生存和治疗结果的因素的最新概述。通过整合现有数据，本综述不仅旨在总结经典的预后变量，还强调可能具有未来临床相关性的新型和未被充分认识的标志物。这种方法可能有助于完善预后模型，支持更准确的患者咨询，并最终帮助优化PDAC患者的治疗策略。
Tumor Characteristics and Clinical Features of the Patient as Prognostic Factors in PDAC
肿瘤(癌症)患者之家