Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, China.
Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
HPB (Oxford). 2018 Nov;20(11):1034-1043. doi: 10.1016/j.hpb.2018.04.010. Epub 2018 Jun 19.
Pancreatic head adenocarcinoma is commonly diagnosed at an advanced stage when adjacent vascular invasion is present. This study aimed to establish a preoperative prognostic nomogram for patients who underwent attempted curative resectional surgery for pancreatic head cancer with suspected peripancreatic venous invasion.
Data on all consecutive patients were retrospectively collected from 2012 to 2016 at four academic institutions. The demographic and radiological parameters were analyzed using univariate and multivariate Cox regression analyses. The final nomogram was established using the concordance Harrell's C-indices and calibration curves from data obtained in three institutions and validated in the cohort of patients coming from the fourth institution.
The nomogram was constructed using data from 178 patients while the validation cohort consisted of 61 patients. Age, length of tumor contact, peripancreatic venous abnormalities and lymph node staging were independent factors of overall survival. The nomogram showed good probabilities of survival on calibration curves. The C-index of the model in predicting overall survival (OS) was 0.824 for the validation cohort.
The nomogram accurately predicted OS in patients with pancreatic head cancer with suspected peripancreatic venous invasion after attempted curative pancreatic resectional surgery.
胰腺头部腺癌通常在存在邻近血管侵犯时被诊断为晚期。本研究旨在为疑似胰周静脉侵犯的接受根治性切除术的胰腺头癌患者建立术前预后列线图。
从 2012 年至 2016 年，在四个学术机构中回顾性地收集了所有连续患者的数据。使用单变量和多变量 Cox 回归分析来分析人口统计学和影像学参数。使用来自三个机构的数据获得的一致性 Harrell 的 C 指数和校准曲线，并在来自第四个机构的患者队列中进行验证，最终建立了列线图。
该列线图是使用 178 名患者的数据构建的，而验证队列则由 61 名患者组成。年龄、肿瘤接触长度、胰周静脉异常和淋巴结分期是总生存的独立因素。校准曲线显示该模型对生存率的预测良好。该模型预测总生存（OS）的 C 指数在验证队列中为 0.824。
对于疑似胰周静脉侵犯的接受根治性胰腺切除术的胰腺头癌患者，该列线图准确预测了 OS。
