胰腺癌仍然是癌症相关死亡的主要原因。为了个体化管理和改善生存率，需要更准确的预后模型。对2009年至2019年期间在瑞典一家三级中心接受胰腺导管腺癌切除术的所有患者进行了全面分析，包括病理和临床参数，包括肿瘤分级，切缘状态，腹主动脉淋巴结参与（淋巴结区16），以及全身治疗。研究队列包括275名患者。总体中位生存期为21.2个月（95％CI 17.5-24.8）。切除年份，切缘状态（R1细分为R11mm / R1ink），神经周围侵犯，分化程度，TNM分期和辅助治疗是对生存率具有显著影响的独立因素。切缘状态还显著影响无复发生存期和复发模式，R1状态与局部和腹膜复发有关（p < 0.001 和 p = 0.007）。淋巴结区16的转移与较短的无复发生存期相关，相比之下，N1状态仅与此有关。切除胰腺癌的生存率随时间的推移而有所改善。切缘状态是影响复发模式和预后的关键因素。考虑到区16转移患者的复发生存率较低，切除的合理性仍然存在疑问，因此有必要改进该患者群体的治疗策略。© 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Pancreatic cancer remains a leading cause of cancer-related death. To individualise management and improve survival, more accurate prognostic models are needed.All patients resected for pancreatic ductal adenocarcinoma in a tertiary Swedish centre during 2009-2019 were thoroughly analysed with regards to pathological and clinical parameters including tumour grade, resection margin status, para-aortic lymph node engagement (node station 16), and systemic treatment.The study cohort included 275 patients. Overall median survival was 21.2 months (95% CI 17.5-24.8). Year of resection, margin status (R1 subdivided into R11mm/R1ink), perineural invasion, differentiation grade, TNM stage, and adjuvant therapy were independent factors with significant impact on survival. Margin status also significantly affected recurrence-free survival and relapse patterns, with local and peritoneal relapses being associated with R1-status (p < 0.001 and p = 0.007). Presence of para-aortic lymph node metastases was associated with shorter recurrence-free survival as compared to N1 status only.Survival in resected pancreatic cancer is improving over time. Resection margin status is a key factor affecting recurrence patterns and prognosis. Given the poor recurrence-free survival in node station 16 metastasised patients, the rational for resection remains in doubt, and improved treatment strategies for this patient group is necessary.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.