ArticleFrontiers in medicine2026
Dynamic perioperative CA19-9 and inflammatory-nutritional recovery patterns are associated with early recurrence and survival after resection for pancreatic ductal adenocarcinoma: a real-world cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Early recurrence after resection for pancreatic ductal adenocarcinoma (PDAC) remains common and is not fully captured by conventional clinicopathologic variables. This study evaluated whether dynamic perioperative CA19-9 and inflammatory-nutritional recovery patterns were associated with early recurrence and survival after curative-intent resection. Methods: This real-world cohort study included patients with pathology-confirmed PDAC who underwent curative-intent R0/R1 resection at The Third People's Hospital of Yunnan Province. Postoperative biomarker assessments were defined at postoperative days (PODs) 21-45 and 75-105. A transparent three-level dynamic pattern integrated early CA19-9 behavior with 3-month NLR, CRP, and PNI recovery; 255 of 268 patients were classifiable. Because exposure ascertainment extended through POD 105, exposure-dependent analyses used a common POD-105 landmark. The primary outcome was recurrence within 12 months; secondary outcomes were recurrence-free survival (RFS) and overall survival (OS). Multivariable regression, 1,000-replicate bootstrap internal validation, and competing-risk sensitivity analysis were used. Results: Among 268 included patients, 78 (29.1%) experienced early recurrence, 149 (55.6%) developed recurrence during follow-up, and 130 (48.5%) died. In the primary dynamic-pattern cohort ( Conclusion: A poor postoperative dynamic recovery pattern was consistently associated with higher early-recurrence risk and shorter RFS and OS after PDAC resection. The dynamic pattern provided modest incremental discriminative information beyond clinicopathologic variables, but performance remained moderate after internal validation. External validation is required before clinical implementation.
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