Development of a Nomogram to Predict Disease-Specific Survival for Patients After Resection of a Non-Metastatic Adenocarcinoma of the Pancreatic Body and Tail

Yiping Zou; Hongwei Han; Shiye Ruan; Zhixiang Jian; Liang Jin; Yuanpeng Zhang; Zhihong Chen; Zi Yin; Zuyi Ma; Haosheng Jin; Menghua Dai; Ning Shi

doi:10.3389/fonc.2020.526602

Development of a Nomogram to Predict Disease-Specific Survival for Patients After Resection of a Non-Metastatic Adenocarcinoma of the Pancreatic Body and Tail

Front Oncol. 2020 Oct 29:10:526602. doi: 10.3389/fonc.2020.526602. eCollection 2020.

Authors

Yiping Zou^{1

2}, Hongwei Han^{1

3}, Shiye Ruan¹, Zhixiang Jian¹, Liang Jin¹, Yuanpeng Zhang¹, Zhihong Chen^{1

2}, Zi Yin¹, Zuyi Ma^{1

2}, Haosheng Jin^{1

2

3}, Menghua Dai⁴, Ning Shi^{1

4}

Affiliations

¹ Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Shantou University Medical College, Shantou, China.
³ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁴ Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Background: Models for predicting patient survival after resection of a non-metastatic adenocarcinoma of the pancreatic body and tail (APBT) are scarce. We wished to establish and validate a nomogram to predict disease-specific survival (DSS) of these patients.

Methods: A total of 1,435 patients screened from the Surveillance, Epidemiology, and End Results (SEER) database were included and divided randomly into a training set (TS; n = 1,007) and internal validation set (IVS; n = 428) at a ratio of 7:3. Cox regression analyses were conducted to select independent predictors in the TS, and a nomogram was constructed. The model was subjected to the IVS and an external validation set (EVS) comprising 151 patients from two tertiary hospitals.

Results: Five independent risk factors (age at the diagnosis, chemotherapy, tumor grade, T stage, and the lymph node radio) were identified and integrated into the nomogram. Calibration curves indicated that the nomogram could predict DSS at 1, 2, and 3 years accurately. The nomogram had a higher concordance index for predicting DSS compared with that using the 8th edition of the American Joint 23 Committee on Cancer (AJCC8) stage (TS: 0.681 vs. 0.606; IVS: 0.662 vs. 0.590; and EVS: 0.675 vs. 0.608). The nomogram had better discrimination ability and clinical utility than the AJCC8 stage for predicting 1-, 2-, and 3-year DSS.

Conclusion: Our developed nomogram could accurately predict DSS in patients after resection of a non-metastatic APBT.

Keywords: SEER database; nomogram; pancreatic body and tail adenocarcinoma; prognosis; risk factors.