A nomogram to preoperatively predict 1-year disease-specific survival in resected pancreatic cancer following neoadjuvant chemoradiation therapy

作     者：Ho Kyoung Hwang Keita Wada Ha Yan Kim Yuichi Nagakawa Yosuke Hijikata Yota Kawasaki Yoshiharu Nakamura Lip Seng Lee Dong Sup Yoon Woo Jung Lee Chang Moo Kang Ho Kyoung Hwang;Keita Wada;Ha Yan Kim;Yuichi Nagakawa;Yosuke Hijikata;Yota Kawasaki;Yoshiharu Nakamura;Lip Seng Lee;Dong Sup Yoon;Woo Jung Lee;Chang Moo Kang

作者机构：Division of HBP SurgeryDepartment of SurgeryYonsei University College of MedicineSeoul 03722Korea Pancreatobiliary Cancer ClinicYonsei Cancer CenterSeverance HospitalSeoul 03722Korea Department of SurgeryTeikyo University School of MedicineTokyo 173-8605Japan BiostatisticianBiostatistics Collaboration UnitDepartment of Biomedical Systems InformaticsYonsei University College of MedicineSeoul 03722Korea Department of Gastrointestinal and Pediatric SurgeryTokyo Medical UniversityTokyo 160-8402Japan Department of Digestive SurgeryBreastand Thyroid SurgeryGraduate School of Medical SciencesKagoshima UniversityKagoshima 890-0065Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic SurgeryNippon Medical SchoolTokyo 890-0065Japan Department of General SurgeryChangi General HospitalSingapore 529889Singapore 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2020年第32卷第1期

页      面：105-114页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by a faculty research grant of Yonsei University College of Medicine for 6-2015-0053 

主　　题：Pancreatic cancer neoadjuvant treatment pancreatectomy survival nomogram 

摘      要：Objective: This study aimed to develop a nomogram to predict the 1-year survival of patients with pancreatic cancer who underwent pancreatectomy following neoadjuvant treatment with preoperatively detectable clinical parameters. Extended pancreatectomy is necessary to achieve complete tumor removal in borderline resectable and locally advanced pancreatic cancer. However, it increases postoperative morbidity and mortality rates, and should be balanced with potential benefit of long-term ***: The medical records of patients who underwent pancreatectomy following neoadjuvant treatment from January 2005 to December 2016 at Severance Hospital were retrospectively reviewed. Medical records were collected from five international institutions from Japan and Singapore for external ***: A total of 113 patients were enrolled. The nomogram for predicting 1-year disease-specific survival was created based on 5 clinically detectable preoperative parameters as follows: age(year), symptom(no/yes), tumor size at initial diagnostic stage(cm), preoperative serum carbohydrate antigen(CA) 19-9 level after neoadjuvant treatment(34/≥34 U/m L), and planned surgery [pancreaticoduodenectomy(PD)(pylorus-preserving PD)/distal pancreatectomy(DP)/total pancreatectomy]. Model performance was assessed for discrimination and *** calibration plot showed good agreement between actual and predicted survival probabilities;the the Greenwood-Nam-D’Agostino(GND) goodness-of-fit test showed that the model was well calibrated(χ~2=8.24,P=0.5099). A total of 84 patients were used for external validation. When correlating actual disease-specific survival and calculated 1-year disease-specific survival, there were significance differences according to the calculated probability of 1-year survival among the three groups(P=0.044).Conclusions: The developed nomogram had quite acceptable accuracy and clinical feasibility in the decision-making process for the management of p