Dai Dongjun, Wang Yanmei, Hu Xinyang, Jin Hongchuan, Wang Xian
Department of Medical Oncology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China.
Laboratory of Cancer Biology, Key Lab of Biotherapy, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China.
PeerJ. 2020 Feb 10;8:e8412. doi: 10.7717/peerj.8412. eCollection 2020.
We aimed to use competing risk model to assess whether very early onset pancreatic cancer (VEOPC ) (<45 years) had a worse prognosis than older pancreatic cancer (PC) patients, and to build a competing risk nomogram for predicting the risk of death of VEOPC.
We selected pancreatic adenocarcinoma (PDAC) patients as our cohort from the Surveillance, Epidemiology, and End Results (SEER) database. The impact of cancer specific death was estimated by competing risk analysis. Multivariate Fine-Gray regression for proportional hazards modeling of the subdistribution hazard (SH) model based nomogram was constructed, which was internally validated by discrimination and calibration with 1,000 bootstraps.
Our cohort included 1,386 VEOPC patients and 53,940 older patients. We observed that in unresectablePDAC patients, VEOPC had better cancer specific survival (CSS) than each older group (45-59 years, 60-69 years, 70-79 years and >79 years). There was no significant prognostic difference between VEOPC and each older group in resectablePDAC. Our competing nomogram showed well discrimination and calibration by internal validation.
For unresectable PDAC patients, VEOPC had better CSS than older patients. Our competing risk nomogram might be an easy-to-use tool for the specific death prediction of VEOPC patients with PDAC.
我们旨在使用竞争风险模型评估极早期胰腺癌（VEOPC，<45岁）的预后是否比老年胰腺癌（PC）患者更差，并构建一个竞争风险列线图来预测VEOPC的死亡风险。
我们从监测、流行病学和最终结果（SEER）数据库中选择胰腺腺癌（PDAC）患者作为我们的队列。通过竞争风险分析估计癌症特异性死亡的影响。构建基于亚分布风险（SH）模型的多变量Fine-Gray回归比例风险模型列线图，并通过1000次自抽样的区分度和校准进行内部验证。
我们的队列包括1386例VEOPC患者和53940例老年患者。我们观察到，在不可切除的PDAC患者中，VEOPC的癌症特异性生存率（CSS）比每个老年组（45 - 59岁、60 - 69岁、70 - 79岁和>79岁）都要好。在可切除的PDAC中，VEOPC与每个老年组之间没有显著的预后差异。我们的竞争列线图通过内部验证显示出良好的区分度和校准。
对于不可切除的PDAC患者，VEOPC的CSS比老年患者更好。我们的竞争风险列线图可能是一种易于使用的工具，用于预测PDAC的VEOPC患者的特异性死亡。
