Development of an artificial intelligence-based prediction platform for early recurrence of resectable pancreatic cancer after curative surgery–toward future use as an indication for neoadjuvant treatment: a retrospective multicenter cohort study
10.4174/astr.2026.110.2.76
- Author:
So Jeong YOON
1
;
Sung Hyun KIM
;
Hongbeom KIM
;
Sang Hyun SHIN
;
Jin Seok HEO
;
Seung Soo HONG
;
Chang Moo KANG
;
Kyung Sik KIM
;
Ho Kyoung HWANG
;
In Woong HAN
Author Information
1. Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2026;110(2):76-83
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Neoadjuvant treatment (NAT) is now the standard for borderline resectable pancreatic cancer (RPC) and is being considered for RPC. Early recurrence after curative surgery in RPC is often seen as a treatment failure, prompting considerations for NAT. Our goal was to develop an artificial intelligence (AI)-based predictive model utilizing preoperatively available factors to forecast early recurrences of resected RPC.
Methods:This study included 469 patients who underwent surgery for RPC between 2011 and 2019. Clinicopathologic and oncologic data were retrospectively reviewed. Preoperative variables, including laboratory data and imaging findings, were collected. Early recurrence was defined as recurrence occurring within a year after surgery. Deep neural networks were then used to select variables by assessing their importance. A new model predicting early recurrence of RPC was subsequently developed.
Results:Of the patients evaluated, 199 (42.4%) experienced early recurrence. The predictive model included 14 preoperative variables: CA 19-9, preoperative pancreatitis, serum albumin, platelet count, lymphocyte count, the American Society of Anesthesiologists physical status classification, tumor size, monocyte count, age, body mass index, CRP, hemoglobin, WBC count, and CEA. The area under the curve for the model was 0.786 in the training set and 0.734 in the test set.
Conclusion:We developed an AI-based model to predict the early recurrence of RPC using preoperative parameters. By identifying patients at risk of early recurrence, optimal individualized treatments such as NAT can be considered. Future prospective studies are crucial to establish clear indications for NAT in RPC.
