Nomogram for Predicting Overall Survival of Metastatic Pancreatic Cancer Patients based on Inflammatory- Nutritional Biomarkers and HBV Infection

Abstract

Purpose: To develop and validate a nomogram to predict overall survival in patients with metastatic pancreatic cancer (mPC). Patients and methods: This retrospective study included 218 patients with mPC patients who were treated at Guangxi Medical University Cancer Hospital from October 2013 to April 2022. Patients were grouped according to hepatitis B virus infection status. Cox proportional hazard regression identified prognostic factors independently associated with overall survival. Results were used to build a nomogram, which was assessed by internal validation using bootstrap resampling. Results: Patients in the HBV-positive group showed significantly better overall survival than patients in the HBV-negative group (P=0.041). Overall survival was independently associated with the following factors: HBV infection status, sex, chemotherapy, metastatic sites, the combined index of hemoglobin, albumin, lymphocyte, and platelet(HALP),neutrophil-albumin ratio(NAR), as well as levels of CA125. The nomogram showed good predictive power, with an area under curve(AUC) of time-dependent receiver operating characteristic of 0.812, and calibration curves, decision curve analysis indicated good calibration and clinical usefulness for the nomogram to predict overall survival of mPC patients. Conclusion: A nomogram based on HBV infection status and inflammatory-nutritional markers may help predict overall survival of mPC patients and guide personalized clinical treatment.