Table IV.
Clinicopathological characteristics predicting DSS in the standard management and ANH groups.
| Univariate analysis | Multivariate analysis | ||||||||
|---|---|---|---|---|---|---|---|---|---|
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| Characteristics | No. | 5-year DSS, % | MST, months | RR | 95% CI | P-value | RR | 95% CI | P-value |
| Sex | 0.645 | 0.408–1.020 | 0.070 | ||||||
| Male | 63 | 28.8 | 32.1 | ||||||
| Female | 62 | 41.6 | 40.0 | ||||||
| Age, years | 1.427 | 0.908–2.242 | 0.121 | ||||||
| <70 | 65 | 42.0 | 42.6 | ||||||
| ≥70 | 60 | 27.1 | 32.2 | ||||||
| Body mass index, kg/m2 | 0.920 | 0.586–1.442 | 0.811 | ||||||
| <22.1 | 62 | 36.0 | 33.2 | ||||||
| ≥22.1 | 63 | 33.9 | 42.6 | ||||||
| Preoperative biliary drainage | 1.418 | 0.889–2.263 | 0.141 | ||||||
| No | 85 | 39.1 | 38.6 | ||||||
| Yes | 40 | 25.5 | 28.6 | ||||||
| Hemoglobin, g/dl | 0.957 | 0.609–1.505 | 0.850 | ||||||
| <12.9 | 65 | 33.7 | 36.5 | ||||||
| ≥12.9 | 60 | 35.9 | 38.6 | ||||||
| CRP, mg/dl | 1.617 | 1.013–2.581 | 0.025 | 0.931 | 0.566–1.532 | 0.779 | |||
| <0.11 | 60 | 44.8 | 50.0 | ||||||
| ≥0.11 | 65 | 24.2 | 32.2 | ||||||
| Albumin, g/dl | 1.063 | 0.677–1.668 | 0.913 | ||||||
| <3.9 | 64 | 32.7 | 38.6 | ||||||
| ≥3.9 | 61 | 37.2 | 36.5 | ||||||
| Hemoglobin A1c, % | 1.134 | 0.703–1.832 | 0.254 | ||||||
| <6.0 | 58 | 41.6 | 42.6 | ||||||
| ≥6.0 | 55 | 28.7 | 33.2 | ||||||
| Creatinine, mg/dl | 0.891 | 0.567–1.400 | 0.616 | ||||||
| <0.67 | 66 | 30.2 | 38.1 | ||||||
| ≥0.67 | 59 | 40.0 | 36.5 | ||||||
| AST, U/l | 1.609 | 1.023–2.531 | 0.038 | 1.422 | 0.831–2.434 | 0.119 | |||
| <27 | 64 | 42.0 | 43.5 | ||||||
| ≥27 | 61 | 26.9 | 29.4 | ||||||
| ALT, U/l | 1.349 | 0.859–2.119 | 0.192 | ||||||
| <28 | 63 | 40.0 | 41.6 | ||||||
| ≥28 | 62 | 29.5 | 32.2 | ||||||
| Total bilirubin, mg/dl | 1.236 | 0.788–1.939 | 0.355 | ||||||
| <0.7 | 67 | 35.7 | 40.0 | ||||||
| ≥0.7 | 58 | 33.1 | 32.2 | ||||||
| CA19-9, U/ml | 1.524 | 0.970–2.395 | 0.066 | ||||||
| <68 | 63 | 40.4 | 42.6 | ||||||
| ≥68 | 62 | 29.4 | 31.4 | ||||||
| CEA, ng/ml | 1.418 | 0.904–2.224 | 0.126 | ||||||
| <2.7 | 67 | 40.2 | 40.0 | ||||||
| ≥2.7 | 58 | 28.2 | 31.4 | ||||||
| Tumor size, mm | 1.499 | 0.955–2.352 | 0.076 | ||||||
| <30 | 71 | 41.6 | 38.1 | ||||||
| ≥30 | 54 | 26.0 | 36.5 | ||||||
| UICC T category | 4.570 | 1.667–12.530 | 0.001 | 3.045 | 1.071–8.657 | 0.037 | |||
| T1 | 18 | 73.8 | 53.0 | ||||||
| T2-3 | 107 | 28.4 | 32.1 | ||||||
| UICC N category | 2.245 | 1.387–3.634 | 0.001 | 2.225 | 1.275–3.883 | 0.005 | |||
| N0 | 55 | 52.1 | 42.8 | ||||||
| N1-2 | 70 | 20.8 | 28.6 | ||||||
| UICC M category | 1.521 | 0.758–3.051 | 0.235 | ||||||
| M0 | 115 | 37.8 | 38.1 | ||||||
| M1a | 10 | 0 | 30.8 | ||||||
| R0 resection | 1.239 | 0.595–2.578 | 0.278 | ||||||
| No | 12 | 31.3 | 21.0 | ||||||
| Yes | 113 | 35.3 | 38.3 | ||||||
| Procedure | 0.829 | 0.520–1.322 | 0.430 | ||||||
| PD, TP | 75 | 31.6 | 36.1 | ||||||
| DP | 50 | 39.6 | 38.6 | ||||||
| Portal vein resection | 1.015 | 0.487–2.112 | 0.969 | ||||||
| No | 109 | 34.0 | 38.1 | ||||||
| Yes | 16 | 44.4 | 33.0 | ||||||
| Operation time, min | 1.357 | 0.864–2.129 | 0.183 | ||||||
| <275 | 63 | 39.5 | 40.4 | ||||||
| ≥275 | 62 | 29.6 | 33.0 | ||||||
| Anesthesia time, min | 1.131 | 0.721–1.774 | 0.591 | ||||||
| <363 | 63 | 37.5 | 38.3 | ||||||
| ≥363 | 62 | 31.8 | 36.5 | ||||||
| Intraoperative blood loss, ml | 1.180 | 0.752–1.851 | 0.471 | ||||||
| <600 | 63 | 37.8 | 38.6 | ||||||
| ≥600 | 62 | 31.8 | 36.5 | ||||||
| ANH | 1.651 | 1.046–2.605 | 0.029 | 1.876 | 1.174–2.998 | 0.009 | |||
| No | 81 | 40.6 | 41.6 | ||||||
| Yes | 44 | 24.1 | 23.5 | ||||||
| Intraoperative fluid given, ml | 1.017 | 0.647–1.600 | 0.941 | ||||||
| <3,500 | 68 | 33.1 | 36.7 | ||||||
| ≥3,500 | 57 | 36.7 | 36.5 | ||||||
| Intraoperative urine output, ml | 1.461 | 0.930–2.295 | 0.098 | ||||||
| <465 | 64 | 40.8 | 42.6 | ||||||
| ≥465 | 61 | 27.9 | 33.2 | ||||||
| Total in-out balance, ml | 1.174 | 0.748–1.842 | 0.484 | ||||||
| <2,210 | 63 | 35.0 | 40.0 | ||||||
| ≥2,210 | 62 | 34.8 | 36.1 | ||||||
| Total in-out balance, ml/kg/h | 1.405 | 0.895–2.204 | 0.260 | ||||||
| <6.6 | 62 | 37.2 | 40.4 | ||||||
| ≥6.6 | 63 | 32.6 | 33.0 | ||||||
| Postoperative complications | 1.440 | 0.792–2.620 | 0.229 | ||||||
| Clavien-Dindo grade 0–2 | 108 | 37.7 | 36.7 | ||||||
| Clavien-Dindo grade ≥3 | 17 | 19.9 | 43.5 | ||||||
| Pancreatic fistula | 1.421 | 0.767–2.635 | 0.262 | ||||||
| ISGPF grade non-A | 109 | 37.2 | 36.7 | ||||||
| ISGPF grade B-C | 16 | 21.4 | 21.2 | ||||||
| Postoperative hospital stay, days | 1.201 | 0.765–1.885 | 0.425 | ||||||
| <17 | 64 | 39.8 | 38.1 | ||||||
| ≥17 | 61 | 29.9 | 36.5 | ||||||
| Adjuvant chemotherapy | 0.407 | 0.247–0.671 | <0.001 | 0.268 | 0.151–0.477 | <0.001 | |||
| No | 27 | 9.1 | 20.8 | ||||||
| Yes | 98 | 41.2 | 42.6 | ||||||
All of the patients were diagnosed with M1 due to positive lymph nodes other than the regional lymph nodes. Since red blood cell transfusion has been shown to affect cancer prognosis negatively (18), the clinicopathological factors influencing DSS in subjects, excluding the ABT group, were evaluated. P-values were obtained using Cox regression analysis. ALT, alanine aminotransferase; ANH, acute normovolemic hemodilution; AST, aspartate aminotransferase; CA19-9, carbohydrate antigen 19-9; CEA, carcinoembryonic antigen; CRP, C-reactive protein; DP, distal pancreatectomy; DSS, disease-specific survival; ISGPF, International Study Group of Pancreatic Fistula; MST, median survival time; PD, pancreatoduodenectomy; RR, relative risk; TP, total pancreatectomy; UICC, Union for International Cancer Control.