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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2025; 31(35): 109687
Published online Sep 21, 2025. doi: 10.3748/wjg.v31.i35.109687
Published online Sep 21, 2025. doi: 10.3748/wjg.v31.i35.109687
Preoperative risk stratification of early recurrence in resected pancreatic ductal adenocarcinoma: Novel equilibrium-phase-computed tomography biomarker of extracellular volume
Zhi-Wei Zhang, Hao-Tian Liu, Zhuo-Hang Zhou, Hong-Fan Liao, Lan-Ling Zhang, Yong-Mei Li, Hong-Wei Liang, Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Co-first authors: Zhi-Wei Zhang and Hao-Tian Liu.
Co-corresponding authors: Yong-Mei Li and Hong-Wei Liang.
Author contributions: Liang HW, Liu HT, Zhou ZH contributed to material preparation, data collection and analysis; Liao HF and Zhang LL contributed to study monitoring; Liang HW contributed to the first draft of the manuscript; Li YM and Zhang ZW contributed to manuscript editing and reviewing; All authors contributed to the study conception and design, read and approved the final manuscript.
Supported by the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau), No. 2025MSXM043.
Institutional review board statement: The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University (No. K2023-356).
Informed consent statement: Due to the retrospective nature of the study, the informed consent form was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Wei Liang, PhD, Doctor, Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. lianghongwei2021@163.com
Received: May 26, 2025
Revised: June 21, 2025
Accepted: August 15, 2025
Published online: September 21, 2025
Processing time: 118 Days and 6.5 Hours
Revised: June 21, 2025
Accepted: August 15, 2025
Published online: September 21, 2025
Processing time: 118 Days and 6.5 Hours
Core Tip
Core Tip: This study demonstrates that preoperative computed tomography (CT)-derived extracellular volume (CT-ECV) is an independent predictor of early recurrence in pancreatic ductal adenocarcinoma after R0 resection. Elevated CT-ECV, high carbohydrate antigen 19-9 (CA19-9), and poor tumor grade were significantly associated with shorter recurrence-free survival. Combining CT-ECV and CA19-9 improved predictive accuracy over tumor grade alone, offering a non-invasive tool for preoperative risk stratification and personalized postoperative management.