1. Nomogram for Estimating Overall Survival in Patients With Metastatic Pancreatic Cancer
- Author
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Michele Reni, David Goldstein, Chrystal U. Louis, Josep Tabernero, Marc F. Botteman, Abdalla Aly, Chee Khoon Lee, Daniel D. Von Hoff, Sandra Margunato-Debay, Desmond McGovern, Brian Lu, E. Gabriela Chiorean, Ramesh K. Ramanathan, Institut Català de la Salut, [Goldstein D] Department of Medical Oncology, Prince of Wales Hospital, Randwick. Prince of Wales Clinical School, University of New South Wales, New South Wales, Australia. [Von Hoff DD] Division of Molecular Medicine, Translational Genomics Research Institute, Phoenix, AZ. HonorHealth, Scottsdale, AZ. [Chiorean EG] Department of Medicine and Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA. [Reni M] Department of Oncology, San Raffaele Scientific Institute, Milan, Italy. [Tabernero J] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. UVic-UCC, IOB-Quiron, CIBERONC, Barcelona, Spain. [Ramanathan RK] Department of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,Oncology ,Nomografia (Matemàtica) ,Endocrinology, Diabetes and Metabolism ,Kaplan-Meier Estimate ,Deoxycytidine ,0302 clinical medicine ,Endocrinology ,metastatic pancreatic cancer ,Antineoplastic Combined Chemotherapy Protocols ,Outcome Assessment, Health Care ,Medicine ,Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Investigative Techniques::Nomograms [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,nab-paclitaxel plus gemcitabine ,neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas [ENFERMEDADES] ,Liver Neoplasms ,Prognosis ,030220 oncology & carcinogenesis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,030211 gastroenterology & hepatology ,medicine.drug ,medicine.medical_specialty ,Paclitaxel ,Adenocarcinoma ,técnicas de investigación::métodos epidemiológicos::estadística como asunto::modelos estadísticos::técnicas de investigación::nomogramas [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,nomogram ,03 medical and health sciences ,Internal medicine ,Metastatic pancreatic cancer ,Internal Medicine ,Overall survival ,Humans ,Clinical significance ,Proportional Hazards Models ,Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms [DISEASES] ,Pàncrees - Càncer ,Hepatology ,business.industry ,Reproducibility of Results ,Original Articles ,Metastatic Pancreatic Adenocarcinoma ,Nomogram ,Gemcitabine ,Confidence interval ,clinical variables ,Pancreatic Neoplasms ,Clinical trial ,Nomograms ,Multivariate Analysis ,business - Abstract
Supplemental digital content is available in the text., Objectives This analysis investigated nomogram use to evaluate metastatic pancreatic cancer prognosis. Methods Thirty-four baseline factors were examined in the Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT) (nab-paclitaxel plus gemcitabine vs gemcitabine) data set. Factors significantly (P < 0.1) associated with overall survival (OS) in a univariable model or with known clinical relevance were tested further. In a multivariable model, factors associated with OS (P < 0.1) were selected to generate the primary nomogram, which was internally validated using bootstrapping, a concordance index, and calibration plots. Results Using data from 861 patients, 6 factors were retained (multivariable analysis): neutrophil-lymphocyte ratio, albumin level, Karnofsky performance status, sum of longest diameter of target lesions, presence of liver metastases, and previous Whipple procedure. The nomogram distinguished low-, medium-, and high-risk groups (concordance index, 0.67; 95% confidence interval, 0.65–0.69; median OS, 11.7, 8.0, and 3.3 months, respectively). Conclusions This nomogram may guide estimates of the range of OS outcomes and contribute to patient stratification in future prospective metastatic pancreatic cancer trials; however, external validation is required to improve estimate reliability and applicability to a general patient population. Caution should be exercised in interpreting these results for treatment decisions: patient characteristics could differ from those included in the nomogram development.
- Published
- 2020