Nomogram for Estimating Overall Survival in Patients With Metastatic Pancreatic Cancer.

Abstract

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.

• Authors: David Goldstein, Daniel D Von Hoff, E Gabriela Chiorean, Michele Reni, Josep Tabernero, Ramesh K Ramanathan, Marc Botteman, Abdalla Aly, Sandra Margunato-Debay, Brian Lu, Chrystal U Louis, Desmond McGovern, Chee Khoon Lee
• Journal: Pancreas (Pancreas) Vol. 49 Issue 6 Pg. 744-750 (07 2020) ISSN: 1536-4828 [Electronic] United States
• PMID: 32541630 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Deoxycytidine
• Paclitaxel
• Gemcitabine

Topics

• Adenocarcinoma (drug therapy, pathology)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Female
• Humans
• Kaplan-Meier Estimate
• Liver Neoplasms (secondary)
• Male
• Multivariate Analysis
• Nomograms
• Outcome Assessment, Health Care (methods, statistics & numerical data)
• Paclitaxel (administration & dosage)
• Pancreatic Neoplasms (drug therapy, pathology)
• Prognosis
• Proportional Hazards Models
• Reproducibility of Results
• Gemcitabine