Nomogram and competing risk model to predict recurrence after curative surgical resection of PDAC |
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| Institution: | 1. Cedars Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA;3. Center for Research on Healthcare Data Center, University of Pittsburgh, Pittsburgh, PA, USA;4. Mercy Clinic Gastroenterology, St. Louis, MO, USA;5. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;6. Aurora St. Luke''s Medical Center, Milwaukee, WI, USA;7. Gastroenterology Associates, Richmond, VA, USA;8. Pancreatitis Center, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;9. Division of Gastroenterology and Hepatology, University of Alabama Birmingham, AL, USA;10. Gastro Health, Baptist Health, Miami, FL, USA;1. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, 55455, USA;2. Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, USA;3. Saint Louis University Center for Outcomes Research, St Louis, MO, USA;1. Digestive Molecular Clinical Oncology Research Unit, Università Degli Studi di Verona, Verona, Italy;2. Section of Medical Oncology, Università Degli Studi di Verona, Verona, Italy;3. Patological Anatomy Unit, Pederzoli Hospital, Peschiera Del Garda, Verona, Italy;4. Pancreatic Surgical Unit, Pederzoli Hospital, Peschiera Del Garda, Verona, Italy;5. Medical Oncology Unit, Azienda USL Toscana Nord Ovest, Carrara, Massa Carrara, Italy;6. Roche S.p.A., Milano, Italy;1. Dept. of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India;2. Wellcome-DBT Indian Alliance Labs., Institute of Basic and Translational Research, Asian Healthcare Foundation, Hyderabad, India;3. Dept. of General Medicine, Sapporo Medical University, Japan;4. Dept. of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India;1. Department of Gastrointestinal Surgery, Aalborg University Hospital, Denmark;2. Department of Clinical Science, Aalborg University, Denmark;3. Clinical Cancer Research Center, Aalborg University Hospital, Denmark;1. Medical Doctor, Erzincan University, Department of Radiology, Erzincan, Turkey;2. Associate Professor, Erzincan University, Department of Radiology, Erzincan, Turkey;3. Professor, Erzincan University, Department of Radiology, Erzincan, Turkey;4. Professor, Erzurum Ataturk University, Department of Radiology, Erzurum, Turkey |
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| Abstract: | BackgroundSurgical resection remains the only potentially curative treatment for pancreatic ductal adenocarcinoma (PDAC). However, a number of patients get disease recurred in a short time post-operation. Few studies have focused on the predictors of different recurrence patterns of PDAC.ObjectiveTo try to establish and verify a nomogram to predict recurrence free survival (RFS) in PDAC patients, and to distinguish the risk factors of local recurrence first and distant metastasis first via competing risk model.MethodsPatients who underwent radical pancreatectomy for PDAC in our center from 2010 to 2018 were reviewed retrospectively. Kaplan-Meier methods and multivariate Cox regression analyses were used to identify the clinicopathological predictors of recurrence post-operation. And then, a nomogram was constructed and validated. Competing risk regression model was used to compare the predictors between local recurrence group and distant metastasis group.ResultsA total of 200 patients were included into the final analysis, and 153 patients got disease relapsed post-operation. CA19-9 level, vascular resection, tumor differentiation, lymph node ratio (LNR) and adjuvant chemotherapy were identified as independent risk factors for recurrence free survival (RFS) and incorporated into the nomogram. The C-index of the nomogram was 0.650. Competing risk model indicated that the status of lymph-node metastasis was significantly associated the patterns of first relapse.ConclusionsNomogram and competing risk model were constructed to quantify the risk of recurrence following surgery for PDAC. Our findings may be useful for predicting RFS and recurrence pattern in clinical work. |
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| Keywords: | Pancreatic ductal adenocarcinoma Local recurrence Distant metastasis Nomogram Recurrence free survival Competing risk model |
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