Validation of a nomogram for predicting survival after resection for adenocarcinoma of the pancreas.
BACKGROUND
Nomograms are statistical tools providing the overall probability of a specific outcome; they have shown better individual discrimination than the tumour node metastasis staging system in several cancers. The pancreatic nomogram, originally developed in the Memorial Sloan-Kettering Cancer Center (MSKCC) in the USA, combines clinicopathological and operative data to predict disease-specific survival at 1, 2 and 3 years from initial resection.


METHODS
An external patient cohort from a retrospective pancreatic adenocarcinoma database at the Academic Medical Centre in Amsterdam was used to test the validity of the pancreatic adenocarcinoma nomogram. The cohort included 263 consecutive patients who had surgery between January 1985 and December 2004.


RESULTS
Data for all the necessary variables were available for 256 patients (97.3 per cent). At the last follow-up, 35 patients were alive, with a median follow-up of 27 (range 3-114) months. The 1-, 2- and 3-year disease-specific survival rates were 60.8, 30.4 and 16.0 per cent respectively. The nomogram concordance index was 0.61. The calibration analysis of the model showed that the predicted survival did not significantly deviate from the actual survival.


CONCLUSIONS
The MSKCC pancreatic cancer nomogram provided an accurate survival prediction. It may aid in counselling patients and in stratification of patients for clinical trials.
de Castro
S M M
SM
Department of Surgery, Academic Medical Centre, Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Biere
S S A Y
SS
Lagarde
S M
SM
Busch
O R C
OR
van Gulik
T M
TM
Gouma
D J
DJ
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis