Prediction scores of postoperative liver metastasis and long‐term survival of pancreatic head cancer based on the distance between the mesenteric vessels and tumor, preoperative serum carbohydrate antigen 19‐9 level, and lymph node metastasis rate

• Published in: Cancer medicine (Malden, MA) Vol. 12; no. 2; pp. 1064 - 1078
• Main Authors: Jiang, Dan, Fan, Xiaona, Li, Pengfei, Zhou, Yang, Chen, Kaige, Li, Hengzhen, Liu, Jinshuang, Zhang, Wenjing, Dai, Yisheng, Sun, Ning, Li, Zhiwei
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2023; John Wiley and Sons Inc; Wiley
• Subjects: Antigens; CA 19‐9; Cancer therapies; Carbohydrates; Chemotherapy; distance of the superior mesenteric artery; distance of the superior mesenteric vein; Hospitals; Humans; Liver; Liver cancer; Liver Neoplasms - pathology; Liver Neoplasms - surgery; long‐term survival; lymph node ratio; Lymph nodes; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - pathology; Lymphatic system; Medical prognosis; Metastases; Metastasis; Pancreas; Pancreatic cancer; Pancreatic carcinoma; pancreatic head carcinoma; Pancreatic Neoplasms; Pancreatic Neoplasms - pathology; Pancreaticoduodenectomy; Pathology; Patients; postoperative liver metastasis; Prognosis; Regression analysis; Retrospective Studies; Risk factors; Surgery; Survival; Survival Rate; Tumors; Veins & arteries; CA 19-9; distance of the superior mesenteric artery; lymph node ratio; pancreatic head carcinoma; distance of the superior mesenteric vein; postoperative liver metastasis; long-term survival
• DOI: 10.1002/cam4.4957
• ISSN: 2045-7634

Background The shortest distance between the superior mesenteric artery (SMA) or superior mesenteric vein (SMV) and the tumor margin was combined with preoperative serum carbohydrate antigen (CA) 19‐9 and lymph node ratio (LNR) to evaluate joint effects on long‐term survival and liver metastasis in patients with pancreatic head cancer after radical surgery. Methods This retrospective study included 149 patients who underwent pancreaticoduodenectomy for pancreatic head cancer at Harbin Medical University Tumor Hospital from May 2011 to March 2021. The preoperative serum CA 19‐9 level and LNR were combined with the SMA or SMV distance. The joint association between long‐term survival and postoperative liver metastasis was evaluated. Results Based on the receiver operating characteristic curve of postoperative liver metastasis or long‐term survival, the optimal cut‐off values of SMV distance were 3.1 and 0.7 mm, respectively, whereas the optimal cut‐off value of SMA distance was 10.25 mm. The univariate model identified the liver metastasis score (p < 0.001) as a negative factor for postoperative liver metastasis of pancreatic head carcinoma. The SMV distance (p = 0.003), SMA distance (p < 0.001), LNR score (p < 0.001), and survival score (p < 0.001) were negatively correlated with long‐term survival after pancreatic head cancer. The multivariate model highlighted SMA distance (p < 0.001), survival score (p = 0.001), and LNR score (p < 0.001) as independent risk factors for long‐term survival in pancreatic head cancer. Conclusion Liver metastasis score may be an independent predictor of postoperative liver metastasis in patients with pancreatic head cancer. Survival and LNR scores may be independent predictors of long‐term postoperative survival in patients with pancreatic head cancer. However, the LNR score appears to improve long‐term survival. The shortest distance between the superior mesenteric vein (SMV), superior mesenteric artery (SMA), and the edge of the tumor. (A) SMA distance = 10.25 mm, (B) SMV distance = 3.1 mm, (C) SMV distance = 0.7 mm, (D) SMA distance = 0.46 cm, and (E) SMV distance = 0.25 cm. SMA superior mesenteric artery; SMV superior mesenteric vein.