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预测胰十二指肠切除术后远端胆管癌患者总生存期的预后列线图。

Prognostic Nomogram That Predicts Overall Survival of Patients with Distal Cholangiocarcinoma After Pancreatoduodenectomy.

作者信息

Chen Qiao, Li Jiayi, Jin Bao, Wu Xiangan, Shi Yue, Xu Haifeng, Zheng Yongchang, Wang Yingyi, Du Shunda, Lu Xin, Sang Xinting, Mao Yilei

机构信息

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Cancer Manag Res. 2020 Oct 20;12:10303-10310. doi: 10.2147/CMAR.S276393. eCollection 2020.

DOI:10.2147/CMAR.S276393
PMID:33116885
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7585820/
Abstract

PURPOSE

We aimed to develop a nomogram for predicting the prognosis of patients with distal cholangiocarcinoma (DCC) and to compare its performance with that of the American Joint Committee on Cancer (AJCC) TNM system.

PATIENTS AND METHODS

To develop a nomogram, we collected the clinical data of 147 patients diagnosed with DCC who underwent pancreatoduodenectomy. Predictive accuracy and discriminative ability were determined using a concordance index and a calibration curve. Predictive performance was compared with that of a current staging systems for DCC.

RESULTS

Multivariate analysis revealed that jaundice, alcohol consumption, high fibrinogen, poorly differentiated tumor cells, positive lymph nodes, and positive margins were significantly associated with overall survival. These variables were incorporated into the nomogram. The concordance index of the nomogram for predicting overall survival was 0.737 (P<0.001), which is significantly higher than the concordance index values (concordance index = 0.586) acquired using the AJCC TNM system (eighth edition). The calibration curve agreed well with predicted prediction and observed overall survival.

CONCLUSION

We developed a nomogram for predicting the prognoses of patients with distal cholangiocarcinoma, which had superior practical clinical value compared with that of the AJCC TNM system.

摘要

目的

我们旨在开发一种用于预测远端胆管癌（DCC）患者预后的列线图，并将其性能与美国癌症联合委员会（AJCC）TNM系统的性能进行比较。

患者与方法

为了开发列线图，我们收集了147例接受胰十二指肠切除术的DCC确诊患者的临床数据。使用一致性指数和校准曲线确定预测准确性和鉴别能力。将预测性能与当前DCC分期系统的性能进行比较。

结果

多因素分析显示，黄疸、饮酒、高纤维蛋白原、肿瘤细胞分化差、淋巴结阳性和切缘阳性与总生存期显著相关。这些变量被纳入列线图。预测总生存期的列线图一致性指数为0.737（P<0.001），显著高于使用AJCC TNM系统（第八版）获得的一致性指数值（一致性指数=0.586）。校准曲线与预测值和观察到的总生存期吻合良好。

结论

我们开发了一种用于预测远端胆管癌患者预后的列线图，与AJCC TNM系统相比，其具有更高的实际临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/dbcb5a219eb1/CMAR-12-10303-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/6fed770033b0/CMAR-12-10303-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/e2031c6a30dd/CMAR-12-10303-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/dbcb5a219eb1/CMAR-12-10303-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/6fed770033b0/CMAR-12-10303-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/e2031c6a30dd/CMAR-12-10303-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7a/7585820/dbcb5a219eb1/CMAR-12-10303-g0003.jpg

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