Abstract:
OBJECTIVES:This analysis investigated nomogram use to evaluate metastatic pancreatic cancer prognosis. METHODS:Thirty-four baseline factors were examined in the Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT) (nab-paclitaxel plus gemcitabine vs gemcitabine) data set. Factors significantly (P < 0.1) associated with overall survival (OS) in a univariable model or with known clinical relevance were tested further. In a multivariable model, factors associated with OS (P < 0.1) were selected to generate the primary nomogram, which was internally validated using bootstrapping, a concordance index, and calibration plots. RESULTS:Using data from 861 patients, 6 factors were retained (multivariable analysis): neutrophil-lymphocyte ratio, albumin level, Karnofsky performance status, sum of longest diameter of target lesions, presence of liver metastases, and previous Whipple procedure. The nomogram distinguished low-, medium-, and high-risk groups (concordance index, 0.67; 95% confidence interval, 0.65-0.69; median OS, 11.7, 8.0, and 3.3 months, respectively). CONCLUSIONS:This nomogram may guide estimates of the range of OS outcomes and contribute to patient stratification in future prospective metastatic pancreatic cancer trials; however, external validation is required to improve estimate reliability and applicability to a general patient population. Caution should be exercised in interpreting these results for treatment decisions: patient characteristics could differ from those included in the nomogram development.
journal_name
Pancreasjournal_title
Pancreasauthors
Goldstein D,Von Hoff DD,Chiorean EG,Reni M,Tabernero J,Ramanathan RK,Botteman M,Aly A,Margunato-Debay S,Lu B,Louis CU,McGovern D,Lee CKdoi
10.1097/MPA.0000000000001563subject
Has Abstractpub_date
2020-07-01 00:00:00pages
744-750issue
6eissn
0885-3177issn
1536-4828journal_volume
49pub_type
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