Scholarlink

Objective <p>To develop a preoperative composite biomarker model integrating FAR and SII/CA19-9 for predicting survival in distal cholangiocarcinoma (DCC) after pancreatoduodenectomy.</p> Methods <p>This retrospective cohort study analyzed 238 DCC patients (2010–2023). Optimal cut-off were determined by ROC analysis (FAR: 8.85, AUC = 0.602; SII/CA19-9: 8, AUC = 0.668). Intergroup comparisons demonstrated no significant differences between the groups. Survival analysis validated pronounced survival disparities across these groups. Multivariable Cox regression identified independent prognostic factors, and a nomogram was constructed for survival prediction. a nomogram integrated independent risk factors into a predictive model, then calibration curves and decision curve analysis (DCA) collectively validated the model’s prognostic capability.</p> Results <p>The independent Prognostic Factors were FAR &gt; 8.85 (HR = 1.919, 95% CI: 1.333–2.762), SII/CA19-9 ≤ 8 (HR = 0.522, 95% CI: 0.356–0.765), and R1 resection (HR = 0.523, 95% CI: 0.328–0.834). Low SII/CA19-9 (≤ 8) patients had median OS of 17 months vs. 44 months in high-ratio group (<i>P</i> &lt; 0.001). High FAR (&gt; 8.85) correlated with reduced median OS (20 months vs. 51months, <i>P</i> &lt; 0.001). The composite model outperformed AJCC staging (C-index: 0.72 vs. 0.62) and CA19-9 alone (AUC: 0.68 vs. 0.61), with 31% net benefit gain in decision curve analysis.</p> Conclusion <p>The FAR and SII/CA19-9 composite model enhances preoperative prognostication in DCC, stratifying high-risk patients (low SII/CA19-9 and high FAR) for personalized adjuvant strategies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Preoperative combined biomarker model of fibrinogen-to-albumin ratio and systemic immune-inflammation index to carbohydrate antigen 19-9 ratio predicts survival in distal cholangiocarcinoma after pancreatoduodenectomy: a retrospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月11日

查看全文
  • Fangfei Wang,
  • Qiang He,
  • Shaocheng Lyu

摘要

Objective

To develop a preoperative composite biomarker model integrating FAR and SII/CA19-9 for predicting survival in distal cholangiocarcinoma (DCC) after pancreatoduodenectomy.

Methods

This retrospective cohort study analyzed 238 DCC patients (2010–2023). Optimal cut-off were determined by ROC analysis (FAR: 8.85, AUC = 0.602; SII/CA19-9: 8, AUC = 0.668). Intergroup comparisons demonstrated no significant differences between the groups. Survival analysis validated pronounced survival disparities across these groups. Multivariable Cox regression identified independent prognostic factors, and a nomogram was constructed for survival prediction. a nomogram integrated independent risk factors into a predictive model, then calibration curves and decision curve analysis (DCA) collectively validated the model’s prognostic capability.

Results

The independent Prognostic Factors were FAR > 8.85 (HR = 1.919, 95% CI: 1.333–2.762), SII/CA19-9 ≤ 8 (HR = 0.522, 95% CI: 0.356–0.765), and R1 resection (HR = 0.523, 95% CI: 0.328–0.834). Low SII/CA19-9 (≤ 8) patients had median OS of 17 months vs. 44 months in high-ratio group (P < 0.001). High FAR (> 8.85) correlated with reduced median OS (20 months vs. 51months, P < 0.001). The composite model outperformed AJCC staging (C-index: 0.72 vs. 0.62) and CA19-9 alone (AUC: 0.68 vs. 0.61), with 31% net benefit gain in decision curve analysis.

Conclusion

The FAR and SII/CA19-9 composite model enhances preoperative prognostication in DCC, stratifying high-risk patients (low SII/CA19-9 and high FAR) for personalized adjuvant strategies.