Background:

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.

Methods:

We retrospectively reviewed 112 patients with PDAC of pancreatic head after pancreaticoduodenectomy in Guangdong Provincial People’s Hospital between 2014 and 2018.

Results:

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.

Conclusions:

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.

中文翻译：

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胰头胰管腺癌患者胰十二指肠切除术后的预后列线图

背景：

胰头胰腺导管腺癌 (PDAC) 患者的预后仍然很差，即使在可能治愈的 R0 切除后也是如此。本研究的目的是开发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。

方法：

回顾性分析2014-2018年广东省人民医院胰十二指肠切除术后胰头PDAC患者112例。

结果：

使用单变量 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 期、总胆红素 (TBIL)、CA19-9。使用所有子集分析和多变量 Cox 回归分析，我们开发了一个由年龄、AJCC 第 8 期、神经周围侵袭、TBIL 和 CA19-9 组成的列线图，与 OS (0.73) 和 RFS (0.69) 相比，其 C 指数更高仅 AJCC 第 8 阶段（OS：0.66；RFS：0.67）。OS 和 RFS 列线图的受试者工作特征 (ROC) 曲线的曲线下面积 (AUC) 值显着高于其他单一参数，即 AJCC 第 8 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操作系统 C 指数比以前报告的模型更高，

结论：

建立了一个简单实用的胰十二指肠切除术后胰头PDAC患者预后的列线图，显示出令人满意的预测效果，值得在未来进一步评估。