Recurrence scoring system predicting early recurrence for patients with pancreatic ductal adenocarcinoma undergoing pancreatectomy and portomesenteric vein resection

Table 1 Clinicopathological features, %

Features	Training cohort (n = 165)	Validation cohort (n = 112)	P value
Age (years)	61.46 ± 8.262	61.67 ± 8.237	0.836
Sex (male)	55.8	60.7	0.412
Smoking	15.2	15.2	0.995
BMI (kg/m2)	22.0901 ± 2.68962	22.4009 ± 2.78960	0.355
Diabetes mellitus	38.8	38.4	0.947
Pain	69.7	63.4	0.273
Weight loss	23.6	13.4	0.035
Neoadjuvant chemotherapy	26.1	18.8	0.157
Jaundice	28.5	26.8	0.757
Operation types (PD1)	74.5	75.0	0.932
Major complications	6.6	6.3	0.890
Tumor sites2	93.3	95.5	0.441
Tumor size (cm)	3.915 ± 1.6448	3.771 ± 1.6681	0.476
Poor differentiation	49.7	58.9	0.131
Perineural invasion	92.7	94.6	0.526
Portomesenteric vein invasion	49.7	50.9	0.845
Lymph node status (N0)	43.6	42.0	0.783
Pathological stage (stage III)	21.8	21.4	0.938
Recurrence	80.6	80.4	0.953
Early recurrence	42.5	42.7	1.000
Median OS (months)	16.40 (9.67-25.07)	15.60 (9.70-22.70)	0.626
Median RFS (months)	7.40 (2.97-14.85)	7.35 (3.00-15.10)	0.810

¹Pancreaticoduodenectomy.

²Head or neck of pancreas.

BMI: Body mass index; PD: Pancreaticoduodenectomy; OS: Overall survival; RFS: Recurrence free survival.

Table 2 Recurrence sites of early recurrence and delayed recurrence, %

Recurrence site	Recurrence (≤ 6 months)	Recurrence (> 6 months)
Liver	41.2	19.7
Lung	1.0	0.7
Locoregional metastasis	7.2	14.5
Peritoneal and omental metastasis	2.0	5.1
Indeterminate	48.4	29.1

Table 3 Predictive accuracy for early recurrence in training cohort

Training cohort	AUC	95%CI	P value
SRS	0.855	(0.786-0.924)	-
Af_CA19-9	0.795	(0.710-0.880)	0.0362
Af_CEA	0.677	(0.577-0.777)	0.000358
Pre_CA19-9	0.675	(0.576-0.774)	0.000518
Pre_CA125	0.641	(0.538-0.744)	0.00016
Pre_ALB	0.631	(0.526-0.735)	2.20e-05
Pre_NLR	0.563	(0.456-0.670)	1.52e-05
Af_CA125	0.559	(0.453-0.666)	5.14e-06
Af_NAR	0.550	(0.442-0.659)	7.92e-06
Pre_neutrophils	0.548	(0.441-0.655)	2.36e-06
Pre_CEA	0.541	(0.433-0.649)	1.13e-07
Pre_NAR	0.509	(0.402-0.616)	2.68e-07
Af_neutrophils	0.508	(0.401-0.615)	3.08e-08
Af_LMR	0.506	(0.399-0.614)	1.13e-07
Af_lympocytes	0.502	(0.394-0.611)	6.21e-08
Af_NLR	0.495	(0.387-0.603)	6.10e-08
Pre_monocytes	0.487	(0.378-0.595)	2.24e-08
Pre_LMR	0.486	(0.378-0.593)	1.49e-06
Af_monocytes	0.482	(0.375-0.589)	2.91e-07
Af_PAR	0.459	(0.349-0.569)	5.31e-06
Pre_PLR	0.458	(0.350-0.566)	7.86e-08
Pre_lymphocytes	0.457	(0.347-0.567)	1.41e-10
Af_PLR	0.435	(0.328-0.541)	3.88e-06
Af_platelets	0.432	(0.326-0.539)	4.54e-06
Af_ALB	0.428	(0.319-0.536)	1.99e-05
Pre_platelets	0.415	(0.309-0.521)	1.29e-05
Pre_PAR	0.397	(0.293-0.502)	9.95e-06

CA: Carbohydrate antigen; CEA: Carcinoembryonic antigen; ALB: Albumin; NLR: Neutrophils, lymphocytes ratio; PLR: Platelets to lymphocytes ratio; LMR: Lymphocytes to monocytes ratio; NAR: Neutrophil to albumin ratio; PAR: Platelet to albumin ratio; SRS: Serum recurrence score; AUC: Area under the curve.

Table 4 Time-dependent area under the curves of serum recurrence score in training cohort

Time intervals (months)	AUC	95%CI
6	0.8549938	(78.62-92.38)
12	0.8095726	(73.15-88.76)
18	0.7710402	(67.01-87.20)
24	0.7830021	(67.75-88.85)
30	0.7766629	(66.12-89.21)
36	0.7762760	(67.27-87.99)
42	0.7930477	(68.72-89.89)
48	0.7930477	(68.72-89.89)
54	0.7975818	(67.76-91.75)

AUC: Area under the curve.