Prognostic Estimator of Survival for Patients with Localized and Extended Pancreatic Ductal Adenocarcinoma

Abstract

The 18,352 pancreatic ductal adenocarcinoma (PDAC) cases from the Surveillance Epidemiology and End Results (SEER) database were analyzed using the Kaplan-Meier method for the following variables: race, gender, marital status, year of diagnosis, age at diagnosis, pancreatic subsite, T-stage, N-stage, M-stage, tumor size, tumor grade, performed surgery, and radiation therapy. Because the T-stage variable did not satisfy the proportional hazards assumption, the cases were divided into cases with T1- and T2-stages (localized tumor) and cases with T3- and T4-stages (extended tumor). For estimating survival and conditional survival probabilities in each group, a multivariate Cox regression model adjusted for the remaining covariates was developed. Testing the reproducibility of model parameters and generalizability of these models showed that the models are well calibrated and have concordance indexes equal to 0.702 and 0.712, respectively. Based on these models, a prognostic estimator of survival for patients diagnosed with PDAC was developed and implemented as a computerized web-based tool.

Magnesium transporter protein solute carrier family 41 member 1 suppresses human pancreatic ductal adenocarcinoma through magnesium-dependent Akt/mTOR inhibition and bax-associated mitochondrial apoptosis

“…Early diagnosis of this disease remains very difficult, as symptoms do not usually appear in the early stages [4], resulting in the poor prognosis of PDAC. The 5-year survival rate of PDAC was only about 2% with a median survival of about four months [5]. Treatment of PDAC is limited; the best option is surgery, which improves 5-year survival to 20% but is still far from satisfactory [6].…”

Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study

“…Up to 40 % of such lesions are due to pancreatic ductal adenocarcinoma (PDAC), whilst the remainder represent a wide variety of tumor entities including neuroendocrine tumors (NETs), metastases, focal pancreatitis, and small solid-appearing serous cystadenomas [1]. Survival from PDAC depends on the detection of early stage tumors [2], with 5-year survival rates after resection of small PDACs (≤ 15 mm) exceeding 30 % -60 % [3,4]. Moreover, patients with PDACs smaller than 10 mm in diameter have a better prognosis compared with patients with larger lesions [5].…”

A simple matrix to predict treatment success and long-term survival among patients undergoing pancreatectomy

“…4 Multiple factors such as age, tumor size, grade/differentiation, lymphatic invasion (LI), metastases, and treatment modalities have been associated with survival among patients diagnosed with pancreatic cancer. 2,[4][5][6][7] One of the most commonly cited nomograms includes 555 patients with resection of pancreatic adenocarcinoma from Memorial Sloan-Kettering Cancer Center. 1 Although this nomogram and others from high-volume specialty centers provide useful information, they may not be ideal for all patients.…”