Zhuang Hongkai, Zhou Zixuan, Ma Zuyi, Huang Shanzhou, Gong Yuanfeng, Li Zhenchong, Liu Chunsheng, Wang Shujie, Chen Bo, Zhang Chuanzhao, Hou Baohua
Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Shantou University of Medical College, Shantou, China.
Clin Med Insights Oncol. 2021 Jun 18;15:11795549211024149. doi: 10.1177/11795549211024149. eCollection 2021.
The prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) of pancreatic head remains poor, even after potentially curative R0 resection. The aim of this study was to develop an accurate model to predict patients' prognosis for PDAC of pancreatic head following pancreaticoduodenectomy.
We retrospectively reviewed 112 patients with PDAC of pancreatic head after pancreaticoduodenectomy in Guangdong Provincial People's Hospital between 2014 and 2018.
Five prognostic factors were identified using univariate Cox regression analysis, including age, histologic grade, American Joint Committee on Cancer (AJCC) Stage 8th, total bilirubin (TBIL), CA19-9. Using all subset analysis and multivariate Cox regression analysis, we developed a nomogram consisted of age, AJCC Stage 8th, perineural invasion, TBIL, and CA19-9, which had higher C-indexes for OS (0.73) and RFS (0.69) compared with AJCC Stage 8th alone (OS: 0.66; RFS: 0.67). The area under the curve (AUC) values of the receiver operating characteristic (ROC) curve for the nomogram for OS and RFS were significantly higher than other single parameter, which are AJCC Stage 8th, age, perineural invasion, TBIL, and CA19-9. Importantly, our nomogram displayed higher C-index for OS than previous reported models, indicating a better predictive value of our model.
A simple and practical nomogram for patient prognosis in PDAC of pancreatic head following pancreaticoduodenectomy was established, which shows satisfactory predictive efficacy and deserves further evaluation in the future.
即使在进行了可能治愈性的R0切除术后，胰头导管腺癌（PDAC）患者的预后仍然很差。本研究的目的是建立一个准确的模型来预测胰十二指肠切除术后胰头PDAC患者的预后。
我们回顾性分析了2014年至2018年期间在广东省人民医院接受胰十二指肠切除术后的112例胰头PDAC患者。
通过单因素Cox回归分析确定了五个预后因素，包括年龄、组织学分级、美国癌症联合委员会（AJCC）第8版分期、总胆红素（TBIL）、CA19-9。通过全子集分析和多因素Cox回归分析，我们建立了一个由年龄、AJCC第8版分期、神经周围侵犯、TBIL和CA19-9组成的列线图，与单独的AJCC第8版分期相比，该列线图的总生存期（OS）C指数为0.73，无复发生存期（RFS）C指数为0.69（OS：0.66；RFS：0.67）。该列线图的OS和RFS的受试者操作特征（ROC）曲线下面积（AUC）值显著高于其他单一参数，即AJCC第8版分期、年龄、神经周围侵犯、TBIL和CA19-9。重要的是，我们的列线图显示的OS C指数高于先前报道的模型，表明我们的模型具有更好的预测价值。
建立了一个简单实用的胰十二指肠切除术后胰头PDAC患者预后列线图，其显示出令人满意的预测效果，值得未来进一步评估。
