ABSTRACT Background/Purpose Prognostic significance of preoperative patient‐related factors, including oral health status, in pancreatic ductal adenocarcinoma (PDAC) remains unclear. We evaluated the association between preoperative factors—particularly oral health parameters—and long‐term survival after curative PDAC resection. Methods Patients who underwent radical pancreatectomy for PDAC (2014–2022) were retrospectively analyzed. Preoperative factors, including oral health status (natural tooth count and posterior teeth occlusion), clinical characteristics, and immuno‐nutritional markers, were assessed for their association with overall survival (OS). Multivariate models adjusted for established pathological and treatment‐related prognostic variables were further analyzed. Results Of 343 eligible patients, 339 underwent preoperative dental examinations; 135 had ≤ 20 teeth and 204 had ≥ 21 teeth. Patients with ≤ 20 teeth had significantly poorer OS (median survival: 39.1 vs. 60.7 months, p < 0.001). Posterior teeth occlusion was not associated with OS. In multivariate analysis of preoperative factors, natural tooth count was independently associated with OS ( p = 0.003). This association remained significant after adjustment for established prognostic variables ( p = 0.016), whereas other immuno‐nutritional markers did not emerge as independent prognostic factors. Conclusions Post‐PDAC resection, natural tooth count, but not posterior teeth occlusion, is independently associated with OS. Tooth count may reflect long‐term host vulnerability and serve as a prognostic marker in PDAC patients.
Seo et al. (2026) studied this question.