Even after a radical pancreaticoduodenectomy (PD), pancreatic ductal adenocarcinoma (PDAC) is prone to return (including robotic, laparoscopic, and open approaches). For a study, researchers sought to create an online nomogram calculator to forecast long-term survival and early recurrence (ER) within a year of surgery in PDAC patients.
Included were patients who had had radical PD and PDAC. To find independent risk variables, univariate and multivariate logistic regression analyses were utilized. Based on independent risk variables identified in the training cohort, an online nomogram calculator was created and afterward put to the test in the internal and external validation cohorts.
Of the 569 patients that satisfied the eligibility requirements, 310, 155, and 104 patients, respectively, were in the training cohort, internal validation cohort, and external validation cohort. Preoperative carbohydrate antigen19-9 (CA19-9) [Odds Ratio (OR) 1.002; 95% CI 1.001–1.003; P=0.001] was found to be an independent risk factor for ER, as were fibrinogen/albumin (FAR) (OR 1.132; 95% CI 1.012-1.266; P=0.029), N stage (OR 2.291; 95% CI 1.283-4.092; P=0.005), and tumor differentiation (OR 3.321; 95% CI 1.278-8.631; P=0.014). When used to predict ER in the training, internal, and external validation cohorts, the nomogram based on the aforementioned four parameters had good C-statistics of 0.772, 0.767, and 0.765, respectively. Comparing the nomogram to existing staging methods, time-dependent ROC analysis (timeROC) and decision curve analysis (DCA) showed that it had higher diagnostic capabilities and net benefit.
The multi-center study created and validated an online nomogram calculator that accurately and steadily predicted ER and long-term survival in PDAC patients.
Reference: sciencedirect.com/science/article/pii/S1743919122006689
