[Acute pancreatitis in pancreatic cancer: impact on prognosis:a retrospective single-center cohort study].

Abstract

Objective: To investigate the differences in clinical characteristics and prognosis between pancreatic ductal adenocarcinoma (PDAC) patients with and without concurrent acute pancreatitis (AP),and to analyze the impact of AP on the survival of PDAC patients. Methods: This is a retrospective case-control study. Clinical data of 1 030 patients with PDAC admitted to Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to December 2023 were collected. There were 578 males and 452 females, with an age of (62.2±9.7) years (range: 31 to 90 years). Patients were divided into an AP group (n=92) and a non-AP group (n=938) based on whether they had concomitant AP. In the AP group, there were 56 males (60.9%) and 36 females (39.1%); in the non-AP group, there were 522 males (55.7%) and 416 females (44.3%). A 1︰2 propensity score matching (PSM) method was used to match the clinical data of the two groups to control for baseline confounders. Subgroup analyses were performed based on whether patients underwent radical surgery and whether they received chemotherapy. Survival curves before and after PSM were plotted using the Kaplan-Meier method, and the Log-rank test was used to compare the overall survival (OS) time between the two groups. Results: Survival analysis showed that, both before and after PSM, there was no statistically significant difference in OS between the AP group and the non-AP group (both P>0.05). Subgroup analysis results revealed that there was no statistically significant difference in OS between the two groups across all subgroups (all P>0.05). When stratified by whether patients received radical surgery,among those who underwent surgery,patients in the AP group were younger than those in the non-AP group,had a higher proportion of N0 stage,a higher proportion of tumors located in the body and tail of the pancreas,and lower levels of AST, alkaline phosphatase, GGT, direct bilirubin, and preoperative carcinoembryonic antigen compared to the non-AP group (all P<0.05). Among patients who did not undergo surgery, the AP group had a higher proportion of T1 stage (P<0.05), while no statistically significant differences were observed for other variables (all P>0.05). Patients in both groups who received radical surgery and concurrent chemotherapy had the best prognosis,while those who did not receive surgery or chemotherapy had the worst prognosis (P<0.05). Conclusion: The presence of AP is not an independent predictor for long-term survival in PDAC patients; yet, among those undergoing radical surgery, PDAC patients with AP are younger, have earlier N stage, and show lower liver function and carcinoembryonic antigen levels.