Clinicopathological predictive factors in long‐term survivors who underwent surgery for pancreatic ductal adenocarcinoma: A single‐center propensity score matched analysis

Abstract Background Long‐term survivors (LTSs) after pancreatic resection of pancreatic ductal adenocarcinoma (PDAC) represent a particular subgroup of patients that remains poorly understood. The primary endpoint was to identify clinicopathological factors associated with LTSs after pancreatic resection for PDAC. Methods This was a retrospective study of patients who had undergone pancreatic resection for PDAC. Long survival was defined as a patient who survived at least 60 months. Patients were divided in two groups: LTS and short‐term survivor (STS). The two groups were compared regarding epidemiological, clinical, and pathological data. Propensity score matching (PSM) was used to reduce selection bias with a 1:2 ratio. Multivariable analysis of significative predictive factors before and after PSM was done. Results Three hundred and thirty‐three patients were enrolled: 46 (13.8%) in the LTS group and 287 (86.2%) in the STS group. Using PSM, 138 patients were analyzed: 46 in the LTS group and 92 in the STS group. At the multivariate analysis of significative predictive factor after PSM, adjuvant chemotherapy, well‐differentiated tumors (G1), and R0 status were related to long‐term survival ( p = 0.052, 0.010 and p = 0.019, respectively). Kaplan–Meier survival curves confirmed these data. Additionally, Kaplan–Meier survival curves showed that pathological stage I was a favorable factor with respect to stage II, III, and IV. Conclusions Long‐term survival is possible after pancreatic cancer resection, even if in a small percentage. Significant predictors of long‐term survival are administration of adjuvant chemotherapy, American Join Committee on Cancer stage I, well‐differentiated tumor (G1), and R0 resection.