Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, China.
World J Surg Oncol. 2024 Sep 9;22(1):241. doi: 10.1186/s12957-024-03519-x.
This study aimed to construct a novel nomogram based on the number of positive lymph nodes to predict the overall survival of patients with pancreatic head cancer after radical surgery.
2271 and 973 patients in the SEER Database were included in the development set and validation set, respectively. The primary clinical endpoint was OS (overall survival). Univariate and multivariate Cox regression analyses were used to screen independent risk factors of OS, and then independent risk factors were used to construct a novel nomogram. The C-index, calibration curves, and decision analysis curves were used to evaluate the predictive power of the nomogram in the development and validation sets.
After multivariate Cox regression analysis, the independent risk factors for OS included age, tumor extent, chemotherapy, tumor size, LN (lymph nodes) examined, and LN positive. A nomogram was constructed by using independent risk factors for OS. The C-index of the nomogram for OS was 0.652 [(95% confidence interval (CI): 0.639-0.666)] and 0.661 (95%CI: 0.641-0.680) in the development and validation sets, respectively. The calibration curves and decision analysis curves proved that the nomogram had good predictive ability.
The nomogram based on the number of positive LN can effectively predict the overall survival of patients with pancreatic head cancer after surgery.
本研究旨在构建一种基于阳性淋巴结数量的新诺模图,以预测胰头癌根治术后患者的总生存期。
SEER 数据库中分别纳入 2271 例和 973 例患者作为开发集和验证集。主要临床终点为 OS(总生存期)。采用单因素和多因素 Cox 回归分析筛选 OS 的独立预后因素,并基于独立预后因素构建新的诺模图。采用 C 指数、校准曲线和决策分析曲线评估该诺模图在开发集和验证集中的预测效能。
多因素 Cox 回归分析后,OS 的独立预后因素包括年龄、肿瘤范围、化疗、肿瘤大小、检查的淋巴结数量和阳性淋巴结数量。利用 OS 的独立预后因素构建了一个诺模图。该诺模图预测 OS 的 C 指数在开发集和验证集中分别为 0.652(95%CI:0.639-0.666)和 0.661(95%CI:0.641-0.680)。校准曲线和决策分析曲线表明该诺模图具有良好的预测能力。
基于阳性淋巴结数量的诺模图可有效预测胰头癌根治术后患者的总生存期。