Fatores prognósticos pré-operatórios em pacientes com adenocarcinoma ductal da cabeça do pâncreas

Abstract

Objective: To identify preoperative prognostic factors influencing pancreatic cancer survival following curative resection in a single Brazilian institution. Methods: From 2005 to 2018, preoperative clinic demographic and laboratory data were prospectively collected. Survival analysis was performed by the Kaplan-Meier method and the comparison between curves by the log-rank test. For multivariate analysis, the Cox regression model was used. Results: Preoperative factors with significant impact on univariate analysis survival were age equal to or greater than 70 years (p = 0.012) and previous history of cancer (p = 0.026). On multivariate analysis, patients with preoperative serum levels of CA 19.9 from 38 to 554 U / ml had a 3.15 times higher chance of death (HR 3.15; 95% CI 1.01-9.82; p = 0.047), whereas patients with the marker above 554 U / ml evolved 3.96 times more likely than those with the normal dosage (HR 3.96; 95% CI 1.19-13.10; p = 0.024). Patients with previous comorbidities had a 2.90 times higher chance of death than those without associated conditions (HR 2.90; 95% CI 1.10-7.67; p = 0.032). Conclusion: Preoperative factors related to the worsening prognosis of pancreatic ductal adenocarcinoma were advanced age, presence of comorbidities, previous history of cancer, and elevated preoperative serum CA 19.9.