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. 2021 May 27;21(1):624.
doi: 10.1186/s12885-021-08295-5.

Prognostic Nomogram for patients undergoing radical Pancreaticoduodenectomy for adenocarcinoma of the pancreatic head

Chao Wu #  1 , Sheng Zhong Hou #  1 , Zuowei Wu  1 , Xing Huang  1 , Zihe Wang  1 , Bole Tian  2
Affiliations

Prognostic Nomogram for patients undergoing radical Pancreaticoduodenectomy for adenocarcinoma of the pancreatic head

Chao Wu et al. BMC Cancer. .

Abstract

Background: Radical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head. Few studies have reported the clinical characteristics and treatment efficacies of patients undergoing radical pancreaticoduodenectomy for adenocarcinoma of the pancreatic head.

Methods: A total of 177 pancreatic head cancer patients who underwent radical pancreaticoduodenectomy and were pathologically confirmed as having pancreatic ductal adenocarcinoma were screened in the West China Hospital of Sichuan University. The multivariate analysis results were implemented to construct a nomogram. The concordance index (c-index), the area under the curve (AUC) and calibration were utilized to evaluate the predictive performance of the nomogram.

Results: The prognostic nutritional index (PNI), the lymph node ratio (LNR) and the American Joint Committee on Cancer (AJCC) staging served as independent prognostic factors and were used to construct the nomogram. The c-indexes of the nomogram were 0.799 (confidence interval (CI), 0.741-0.858) and 0.732 (0.657-0.807) in the primary set and validation set, respectively. The AUCs of the nomogram at 1 and 3 years were 0.832 and 0.783, which were superior to the AJCC staging values of 0.759 and 0.705, respectively.

Conclusions: The nomogram may be used to predict the prognosis of radical resection for adenocarcinoma of the pancreatic head. These findings may represent an effective model for the developing an optimal therapeutic schedule for malnourished patients who need early effective nutritional intervention and may promote the treatment efficacy of resectable adenocarcinoma of the pancreatic head.

Keywords: Adenocarcinoma of the pancreatic head; Nomogram; Pancreaticoduodenectomy; Prognostic.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The Kaplan–Meier analysis and performance of PNI in predicting 1-and 3-year prognosis respectively in primary set (ab) and validation set (cd)
Fig. 2
Fig. 2
The Kaplan–Meier analysis and the predictive power of LNR in predicting 1-and 3-year prognosis respectively in primary set (ab) and validation set (cd)
Fig. 3
Fig. 3
Nomogram for predicting OS of pancreatic head cancer underwent radical pancreaticoduodenectomy
Fig. 4
Fig. 4
The Calibration curves for the nomogram. Nomogram for predicting 1-, 2-, and 3-year OS respectively in primary set (a) and validation set (b)
Fig. 5
Fig. 5
Comparison of the performance of the nomogram and AJCC stage by AUC at 1 and 3 years in primary set (a) and validation set (b)
Fig. 6
Fig. 6
Decision curve analysis of pancreatic head cancer underwent radical pancreaticoduodenectomy in primary set (a) and validation set (b). The horizontal solid black line assumed no patients would die, and the solid grey line assumed all patients would die
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet. 2016;388(10039):73–85. doi: 10.1016/S0140-6736(16)00141-0. - DOI - PubMed
    1. Strobel O, Neoptolemos J, Jaeger D, Buechler MW. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol. 2019;16(1):11–26. doi: 10.1038/s41571-018-0112-1. - DOI - PubMed
    1. Elshaer M, Gravante G, Kosmin M, Riaz A, Al-Bahrani A. A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma. Ann R Coll Surg Engl. 2017;99(2):101–106. doi: 10.1308/rcsann.2016.0340. - DOI - PMC - PubMed
    1. Morimoto D, Yamada S, Murotani K, Sonohara F, Takami H, Suenaga M, Hayashi M, Niwa Y, Tashiro M, Hattori N. Prognostic impact of portal system invasion in pancreatic cancer based on image classification. Pancreas. 2018;47(10):1350–1356. doi: 10.1097/MPA.0000000000001186. - DOI - PubMed

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