A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

Abstract

BackgroundThis study developed and validated a nomogram to predict patient prognosis for pancreatic ductal adenocarcinoma (PDAC) of the head of the pancreas following pancreaticoduodenectomy.Material/MethodsRetrospective data were obtained from 4,383 patients with PDAC of the head of the pancreas who underwent pancreaticoduodenectomy between 2004–2013 from 11 Registries Research Data of the Surveillance, Epidemiology,and End Results (SEER) database. Cox proportional hazards model was used to identify independent risk factors. The predictive accuracy of the nomogram was determined by the concordance index (C-index) and calibration curve. The results were externally validated by comparison with data from 1,743 patients from 7 other Registries Research Data.ResultsOf the 4,383 patients in the training dataset, median disease-specific survival (DSS) was 17.0 months (range, 1.0–131 months), and postoperative 1-year, 3-year, and 5-year DSS rates were 70.3%, 26.1%, and 16.8%, respectively. Multivariate analysis showed that patient sex, age, tumor grade, regional lymph nodes examined, positive regional lymph nodes, tumor size, extent of local invasion, and tumor metastases were independent risk factors for DSS. The C-index of the internal validation dataset for prediction of DSS was 0.64 (95% CI, 0.63–0.65), which was superior to the American Joint Committee on Cancer (AJCC) staging, 0.57 (95% CI, 0.56–0.58) (P<0.001). The 5-year DSS rates and median DSS time for patients in the low-risk group were significantly greater compared with high-risk group (P<0.001).ConclusionsA validated prognostic disease-specific nomogram for patient survival in PDAC of the head of the pancreas following pancreaticoduodenectomy was developed.

Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database

“…It only incorporates some features of the tumors into the staging system, and the prognostic factors are far more than these. Previous studies have found that age, sex, grade, different treatment and even marital status are important independent factors affecting the prognosis of patients with PC (Li, Zhou & Zhao, 2018;He et al, 2018;Wang et al, 2016;Baine et al, 2011).…”

Predictive Nomogram for Early Recurrence after Pancreatectomy in Resectable Pancreatic Cancer: Risk Classification Using Preoperative Clinicopathologic Factors

“…However, the studies have shown inconsistent results depending on the research institute and the study cohort, and the predictors have not been able to directly contribute to improving prognosis because most of them are unmodifiable factors [3,11,12]. To complement the inconsistency of the prognostic factors of PDAC and to more accurately predict the survival possibility, predictive nomograms developed by analysing the contribution of each factor have been reported [13][14][15][16]. Although these outcomes may contribute to predicting the overall outcomes of a patient, there are still limitations in contributing to prognosis improvement.…”

Intraductal Tubulopapillary Neoplasm of the Pancreas Presenting as a Localized Pancreatic Tumor in a 52-Year-Old Woman: Focusing on a Rare Pancreatic Malignancy and Contrasting to Intrapapillary Mucinous Neoplasm

“…A particular case report in which a patient with ITPN and no metastases underwent pylorus-preserving duodenopancreatectomy showed survival at five months post-surgery with no evidence of remaining disease [ 9 ]. However, the prognosis of ITPN is favorable in comparison to the more commonly encountered pancreatic ductal adenocarcinomas, where median disease-specific survival was 17.0 months in a dataset of 4383 patients [ 10 ]. The patient continues to survive 14 months after diagnosis, and 11 months following pancreatectomy.…”