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
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 1435 patients screened from the Surveillance, Epidemiology, and End Results (SEER) database were included and divided randomly into a training set (TS; n = 1007) 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 American Joint Committee on Cancer (AJCC8) stage (TS: 0.681 vs. 0.606; IVS: 0.662 vs. 0.590; 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.