文章：

可切除性胰腺导管腺癌先行手术后预后预测模型：一项多中心研究（OS-HBP-2）

Prognosis Prediction Model After Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Study (OS-HBP-2)

原文发布日期：18 November 2025

DOI: 10.3390/cancers17223694

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Upfront surgery (UFS) remains the standard treatment for patients with resectable pancreatic ductal adenocarcinoma (PDAC). We aimed to investigate the prognostic factors for survival after UFS in patients with resectable PDAC and to develop a prognostic prediction model.Methods: This multicenter, retrospective study included 603 patients who underwent UFS for resectable PDAC between January 2013 and December 2017. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival (OS). We constructed a prognostic prediction model for OS after UFS. An internal validation was performed to evaluate the discriminative performance of the model.Results: The 1-, 3-, and 5-year OS rates were 83.7%, 48.2%, and 37.5%, respectively. The Cox proportional hazards model showed that tumor size > 2 cm (hazard ratio [HR] 1.50,p= 0.001); tumor contact with the portal and superior mesenteric veins of ≤180° (HR 1.47,p= 0.003); carbohydrate antigen 19-9 levels of 40 to 500 U/mL (HR 1.59,p= 0.002) and ≥500 U/mL (HR 2.16,p< 0.001); and a modified Glasgow Prognostic Score of two (HR 1.56,p= 0.038) were predictors associated with OS. The prognostic prediction model for 5-year OS demonstrated an area under the curve of 0.68. The calibration plots indicate a concordance index of 0.63.Conclusions: We identified the preoperative prognostic factors for OS and developed a prognostic prediction model to estimate OS in patients undergoing UFS for resectable PDAC. Our model may be useful and internally validated for predicting OS.

摘要翻译： 

背景/目的：对于可切除胰腺导管腺癌（PDAC）患者，前期手术（UFS）仍是标准治疗方案。本研究旨在探讨可切除PDAC患者接受UFS后的生存预后因素，并构建预后预测模型。方法：这项多中心回顾性研究纳入2013年1月至2017年12月期间接受UFS治疗的603例可切除PDAC患者。通过单因素和多因素分析确定总生存期（OS）的预后因素，构建UFS术后OS的预后预测模型，并进行内部验证以评估模型的区分性能。结果：患者的1年、3年和5年OS率分别为83.7%、48.2%和37.5%。Cox比例风险模型显示：肿瘤直径>2 cm（风险比[HR] 1.50，p=0.001）、肿瘤与门静脉/肠系膜上静脉接触范围≤180°（HR 1.47，p=0.003）、碳水化合物抗原19-9水平为40-500 U/mL（HR 1.59，p=0.002）及≥500 U/mL（HR 2.16，p<0.001）、改良格拉斯哥预后评分为2分（HR 1.56，p=0.038）是OS的独立预测因素。5年OS预后预测模型的曲线下面积为0.68，校准图显示一致性指数为0.63。结论：本研究明确了可切除PDAC患者接受UFS治疗的术前OS预后因素，并构建了具有内部验证效力的OS预测模型，该模型对临床预后评估具有实用价值。

原文链接：

Prognosis Prediction Model After Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Study (OS-HBP-2)