Long-term outcome and prognostic factors of pancreatic ductal adenocarcinoma after laparoscopic pancreaticoduodenectomy

Abstract

Abstract Pancreatic ductal adenocarcinoma (PDAC) is recognized as one of the most malignant malignancies and has a very poor prognosis. Laparoscopic pancreaticoduodenectomy (LPD) is one of the radical surgeries for early PDAC. However, the long-term survival outcomes of PDAC patients undergoing LPD surgery and what factors influence their prognosis have been rarely reported. To find the answers to these questions, we designed and implemented this study. A total of 141 patients who underwent LPD and had pathologically confirmed PDAC between May 2016 and August 2020 at the Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University(Changchun, China) were enrolled in the study. We followed them regularly after their discharge and collected their clinicopathological data until December 2021. We analyzed these clinicopathological data and performed a survival analysis. During the patients' follow-up period, recurrence occurred in 98 patients; deaths occurred in 93 patients. The median recurrence-free survival (RFS) of PDAC patients was 12.6 months, while the median overall survival (OS) of PDAC patients was 16.3 months. Patients with elevated CA242 and CA19-9 levels, vascular invasion, lymph node metastasis, and tumor size > 3cm had worse prognoses (P < 0.05). In conclusion, elevated CA242 and CA19-9 levels, vascular invasion, lymph node metastasis, and tumor size > 3cm were unfavorable independent prognostic factors for PDAC patients undergoing LPD.