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August 19, 2026BMC SurgeryOpen Access

Prognostic factors for resectable pancreatic adenocarcinoma: a systematic review and meta-analysis

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Authors

RSRen Shu-jieCLChang LiuJYJin Yi

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Overview

Systematic review and meta-analysis reveals multivariable prognostic factors in resected pancreatic adenocarcinoma, indicating the need for comprehensive postoperative risk stratification.

Key Points

  • To identify and synthesize clinical, pathological, biological, and treatment-related prognostic factors associated with overall survival in patients undergoing curative-intent resection for pancreatic ductal adenocarcinoma.
  • Searched PubMed, Embase, Web of Science, and Cochrane Library for observational studies and randomized trials reporting univariable or multivariable hazard ratios for overall survival following pancreatic ductal adenocarcinoma resection.
  • Synthesized data across 52 studies comprising 79,446 patients using fixed- or random-effects models based on heterogeneity.
  • In pooled multivariable analyses, worse overall survival was associated with older age (HR 2.17), elevated CRP/albumin ratio (HR 2.05), pancreaticoduodenectomy vs. distal pancreatectomy (HR 1.76), advanced T stage (HR 1.74), positive resection margin (HR 1.73), node-positive disease (HR 1.68), high CA19-9 (HR 1.63), poor histologic grade (HR 1.63), male sex (HR 1.62), elevated NLR (HR 1.62), and vascular invasion (HR 1.54).
  • Postoperative adjuvant chemotherapy was consistently associated with improved overall survival (HR 0.52), while preoperative CEA and perineural invasion were not statistically significant in multivariable models.

Cite This Study

Shu-jie et al. (2026) studied this question.

synapsesocial.com/papers/6a85643903308d306e2d7db2https://doi.org/10.1186/s12893-026-04105-6
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic Determinants of Overall Survival After Resection for Pancreatic Ductal Adenocarcinoma: A Consensus‐Based Conceptual Framework2026
  2. 2The Value of Biological and Conditional Factors for Staging of Patients with Resectable Pancreatic Cancer Undergoing Upfront Resection: A Nationwide Analysis2024 · 17 citations
  3. 3Predictive factors for long-term survival in pancreatic ductal adenocarcinoma that underwent surgery: a systematic review and meta-analysis of literature2025 · 3 citations
  4. 4Time-varying impact of established prognostic factors in resected pancreatic ductal adenocarcinoma2025 · 3 citations
  5. 5In-Depth Analysis of Post-recurrence Survival in Resected Pancreatic Ductal Adenocarcinoma: A Cohort Study2026