Metabolic syndrome as a prognostic factor in advanced pancreatic cancer: a predictive model and chemotherapy evaluation.

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2025-07-16 DOI:10.1186/s12957-025-03940-w

Jingchang Zhang, Jianbiao Li, Huiting Deng, Yongfu Zhao, Ye Zhang

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Abstract

Objective: This study aimed to identify independent prognostic factors for advanced unresectable pancreatic ductal adenocarcinoma (PDAC) and construct a nomogram-based prediction model. The efficacy of different chemotherapy regimens was evaluated based on metabolic risk levels.

Methods: Clinical data from 276 patients with unresectable PDAC treated between 2020 and 2022 were retrospectively analyzed. Cox proportional hazards regression identified prognostic factors, and survival analysis was performed using Kaplan-Meier methods. A nomogram was developed, and ROC analysis assessed its predictive performance. Two-way ANOVA evaluated chemotherapy efficacy, and TCGA transcriptomic data explored metabolic correlations.

Results: Metabolic syndrome (MetS) and distant metastasis were independent prognostic factors. Patients with MetS had significantly shorter survival. The nomogram showed good discrimination (AUC: 0.815 training, 0.793 validation). Patients without MetS had better outcomes with FOLFIRINOX or GS regimens. Transcriptomic analysis revealed metabolic pathways linked to PDAC progression.

Conclusions: MetS and distant metastasis significantly impact PDAC prognosis. Patients without MetS benefit more from specific chemotherapy regimens. Our predictive model may aid personalized treatment strategies.

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代谢综合征作为晚期胰腺癌的预后因素：预测模型和化疗评估。

目的：探讨晚期不可切除胰导管腺癌（PDAC）的独立预后因素，建立基于形态图的预测模型。根据代谢风险水平评估不同化疗方案的疗效。方法：回顾性分析2020年至2022年276例不可切除PDAC患者的临床资料。Cox比例风险回归确定预后因素，并使用Kaplan-Meier方法进行生存分析。我们开发了一个nomogram，并通过ROC分析来评估其预测性能。双向方差分析评估化疗疗效，TCGA转录组数据探讨代谢相关性。结果：代谢综合征（MetS）和远处转移是独立的预后因素。met患者的生存期明显缩短。模态图具有较好的判别性（训练AUC: 0.815，验证AUC: 0.793）。没有met的患者使用FOLFIRINOX或GS方案有更好的结果。转录组学分析揭示了与PDAC进展相关的代谢途径。结论：转移瘤和远处转移显著影响PDAC预后。没有MetS的患者从特定的化疗方案中获益更多。我们的预测模型可能有助于个性化的治疗策略。

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

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.