Jingchang Zhang, Jianbiao Li, Huiting Deng, Yongfu Zhao, Ye Zhang
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Metabolic syndrome as a prognostic factor in advanced pancreatic cancer: a predictive model and chemotherapy evaluation.
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.
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.
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