Dataset Information

A nomogram prediction of overall survival based on lymph node ratio, AJCC 8th staging system, and other factors for primary pancreatic cancer.

ABSTRACT:

Background

As a malignant tumor with poor prognosis, accurate and effective prediction of the prognosis of pancreatic cancer (PC) is crucial.

Methods

A total of 12,909 patients diagnosed with pancreatic cancer were selected from the Surveillance, Epidemiology, and End Results program between 2004 and 2016. The sex, age, ethnicity, marital status, metastasis status, radiotherapy, chemotherapy, tumor size, regional nodes examined, regional nodes positive of each patient were recorded. Univariate and multivariate Cox regression analyses were used to identify prognostic factors with a threshold of P<0.05, and a nomogram was constructed. Harrell's concordance indexes and calibration plots were used to verify the predictive power of the model. The risk groups were also stratified by quartile of the total score. Survival rates were estimated by the Kaplan-Meier method.

Results

Age, year of diagnosis, sex, grade, histologic, marital, TNM stage, surgery of the primary site, tumor size, regional nodes positive and regional nodes examined ratio (LNR), lymph node dissection, radiotherapy, and chemotherapy were identified as prognostic factors for the construction of the nomogram. The nomogram exhibited a clinical predictive ability of 0.675(95% CI, 0.669~0.681) in the internal verification. The predicted calibration curve was similar to the standard curve. Decision curve analysis showed that the nomogram had value in terms of clinical application. Besides, the nomogram was able to divide the patients into different groups according to total points.

Conclusions

Hence, our nomogram was highly effective in predicting overall survival in patients with PC, which may provide a reference tool for clinicians to guide individualized treatment and follow-ups for patients with PC, accurately determine the 1-,3- and 5-year overall survival of patients.

SUBMITTER: Zhong R

PROVIDER: S-EPMC8099056 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:The prognosis of pancreatic carcinoma (PC) remains poor and the American Joint Committee on Cancer (AJCC) 8th staging system for survival prediction in PC patients after curative resection is still limited. Thus, the aim of this study is to refine a valuable prognostic model and novel staging system for PC with curative resection.The data of 3,458 patients used in this study were retrieved from the Surveillance, Epidemiology, and End Results database registry of National Cancer Institute. The prognostic value of lymph node ratio (LNR) was analyzed in the primary cohort and prognostic nomogram based on the LNR was established to create a novel staging system. Then, analyses were conducted to evaluate the application of the formulated nomogram staging system and the AJCC 8th staging system. The predictive performance of model was further validated in the internal validation cohort.Significant positive correlations were found between LNR and all factors except for surgical procedures. The results of univariate and multivariate analyses showed that LNR was identified as an independent prognostic indicator for overall survival (OS) in both primary and validation cohorts (all P < 0.001). A prognostic nomogram based on the LNR was formulated to obtain superior discriminatory abilities. Compared with the AJCC 8th staging system, the formulated nomogram staging system showed higher hazard ratios of stage II, III, and IV disease (reference to stage I disease) that were 1.637, 2.300, and 3.521, respectively, by univariate analyses in the primary cohort and the distinction between stage I, II, and III disease at the beginning or end of the survival curves was more apparent. All these results were further verified in the validation cohort.LNR can be considered as a useful independent prognostic indicator for PC patients after curative resection regardless of the surgical procedures. Compared with the AJCC 8th staging system, the formulated nomogram showed superior predictive accuracy for OS and its novel staging system revealed better risk stratification.