Important Radiologic and Clinical Factors for Predicting Overall Survival in Pancreatic Adenocarcinoma Patients Who Underwent FOLFIRINOX.

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2024-08-01 Epub Date: 2024-03-13 DOI:10.1097/MPA.0000000000002330

Sae-Jin Park, Jung Hoon Kim, Seo-Youn Choi, Ijin Joo

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引用次数: 0

Abstract

Background: To predict poor overall survival (OS) in pancreatic adenocarcinoma (PAC) who underwent FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) using clinical and computed tomography (CT) findings.

Methods: A total of 189 patients with PAC who received FOLFIRINOX were retrospectively included. Two reviewers assessed CT findings and resectability based on National Comprehensive Cancer Network guidelines. They determined tumor size changes according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Delta measurements were performed. Clinical results, such as whether to perform surgery, were also investigated. A Cox proportional hazard model was used to identify significant predictors for OS. A CT-based nomogram was constructed to predict OS.

Results: Seventy-four patients (39.2%) underwent surgery. For OS, rim enhancement of PAC on baseline CT (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.10-2.77; P = 0.018), high delta tumor on baseline CT (HR, 2.46; 95% CI, 1.55-3.91; P < 0.001), progressive disease at follow-up CT (HR, 8.89; 95% CI, 2.94-26.87; P < 0.001), and without surgery (HR, 2.81; 95% CI, 1.49-5.30; P = 0.001) were important features related to poor prognosis. The nomogram showed good predictive ability for the survival.

Conclusion: Both clinical and CT findings were useful for predicting OS after FOLFIRINOX in PAC.

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预测接受 FOLFIRINOX 治疗的胰腺腺癌患者总生存期的重要放射学和临床因素

研究背景利用临床和计算机断层扫描（CT）结果预测接受FOLFIRINOX（5-氟尿嘧啶/亮霉素/伊立替康/奥沙利铂）治疗的胰腺腺癌（PAC）患者的不良总生存率（OS）：回顾性纳入了189例接受FOLFIRINOX治疗的PAC患者。两名审查员根据美国国家综合癌症网络指南评估CT结果和可切除性。他们根据实体瘤反应评估标准（RECIST 1.1）确定肿瘤大小变化。进行德尔塔测量。他们还调查了临床结果，如是否进行手术。研究人员使用 Cox 比例危险模型来确定 OS 的重要预测因素。结果：74名患者（39.2%）接受了手术。就 OS 而言，基线 CT 上 PAC 边缘增强（危险比 [HR]，1.75；95% 置信区间 [CI]，1.10-2.77；P = 0.018）、基线 CT 上高 delta 肿瘤（HR，2.46；95% CI，1.55-3.91；P < 0.001）、随访 CT 时疾病进展（HR，8.89；95% CI，2.94-26.87；P < 0.001）和未手术（HR，2.81；95% CI，1.49-5.30；P = 0.001）是与预后不良相关的重要特征。结论：临床和CT检查结果都有助于预测癌症的预后：结论：临床和CT结果均有助于预测PAC患者FOLFIRINOX治疗后的OS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.