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Dynamic evaluation of postoperative survival in pancreatic ductal adenocarcinoma
Bo-Wen Zheng1,2, Xin-Yu Yang1,2, Jun Zheng1,2
1Department of Hepato-Pancreato-Biliary Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China.
Abstract:
The pancreatic ductal adenocarcinoma has a high degree of malignancy, and traditional prognostic assessment methods have limited evaluative capacity. This study is based on the Kallikrein-related peptidase 7 (KLK7) expression and uses conditional survival algorithms to perform dynamic survival assessments of patients. The Cox proportional hazards model was employed for identifying and adjusting for potential confounders. The Kaplan-Meier technique was utilized to estimate the overall survival rate. The computation of the likelihood of patients surviving an additional year after X years of survival was achieved using the equation CS1 = OS(X + 1)/OS(X). A subgroup analysis based on CS1 was conducted for each individual risk factor. A total of 243 eligible patients were included in the study. Conditioned survival (CS) refers to the years a patient has already survived and the predicted years they are likely to survive in the future, while conducting a time-varying analysis of the factors influencing prognosis. The survival probability assessed by CS1 increased year by year, with the 1-, 2-, and 3-year survival rates rising from 50.4% to 91.2%. In contrast, the actuarial overall survival (OS) decreased from 81.9% at 1 year to 38.6% at 3 years post-surgery. The results of the conditional analysis indicate that patients who survive longer within a certain timeframe have better survival expectations in the future. Adverse factors, including KLK7, have a decreasing impact on survival over time. Conditional survival analysis based on KLK7 can provide more accurate survival predictions for patients who has identified KLK7.

