Nomogram for Estimating Overall Survival in Patients With Metastatic Pancreatic Cancer. Issue 6 (July 2020)

• Record Type: Journal Article
• Authors: Goldstein, David; Von Hoff, Daniel D.; Chiorean, E. Gabriela; Reni, Michele; Tabernero, Josep; Ramanathan, Ramesh K.; Botteman, Marc; Aly, Abdalla; Margunato-Debay, Sandra; Lu, Brian; Louis, Chrystal U.; McGovern, Desmond; Lee, Chee Khoon
• Is Part Of: Pancreas. Volume 49:Issue 6(2020)
• Publication Date: 2020-07
• Subjects: clinical variables -- metastatic pancreatic cancer -- nab-paclitaxel plus gemcitabine -- nomogram -- prognosis; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001563
• Languages: English
• ISSNs: 0885-3177

Abstract

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. Abstract : Supplemental digital content is available in the text.