Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer

Strijker, Marin; Chen, J.; Mungroop, Timothy H.; Jamieson, Nigel B.; Eijck, Casper van; Steyerberg, Ewout; Wilmink, Johanna W.; Koerkamp, B. Groot; Laarhoven, H.W.M. van; Besselink, Marc G.

doi:10.1016/j.hpb.2020.04.144

Cited by 3 publications

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“…The performance of this model was satisfactory in discrimination aspects in both the development and validation sets. Previous predictive models had limited clinical utility as depending on postsurgical pathology findings to some extent [10,18,19]. Moreover, some researchers investigated the association between PDAC imaging features and clinical outcomes by quantitative or qualitative methods [20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

A predictive model for recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC) by using preoperative clinical data and CT characteristics

et al. 2022

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Background The overall survival for patients with resectable PDAC following curative surgical resection hasn’t been improved significantly, as a considerable proportion of patients develop recurrence within a year. The purpose of this study was to develop and validate a predictive model to assess recurrence risk in patients with PDAC after upfront surgery by using preoperative clinical data and CT characteristics. Methods The predictive model was developed based on a retrospective set of 141 pancreatic cancer patients after surgery. A separate set of 77 patients was used to validate model. Between January 2017 and December 2019, all patients underwent multidetector pancreatic CT and upfront surgery. Univariable and multivariate Cox regression was used to determine the risk factors related to recurrence and then establish a nomogram to estimate the 1-year recurrence probability. The Harrell C-index was employed in evaluating the discrimination and calibration of the model. Results A total of 218 patients in this retrospective cohort. A recurrence model in nomogram form was developed with predictors including tumor size (hazard ratio [HR], 1.277; 95% CI 1.098, 1.495; P = 0.002), tumor density in the portal vein phase (HR, 0.598; 95% CI 0.424, 0.844; P = 0.003), peripancreatic infiltration (HR, 4.151; 95% CI 2.077, 8.298; P < 0.001), suspicious metastatic lymph node (HR, 2.561; 95% CI 1.653, 3.967; P < 0.001), Neutrophils/Lymphocytes ratio (HR, 1.111; 95% CI 1.016, 1.215; P = 0.020). The predictive nomogram had good discrimination capability with these predictors with an area under curve at 1 year of 0.84 (95%CI 0.77, 0.91) in the development set and 0.82 (95% CI 0.72, 0.92) and 0.84 (95% CI 0.74, 0.94) in the validation set for two radiologists reading respectively. Conclusions The model developed based on preoperative clinical data and CT characteristics of resectable pancreatic ductal adenocarcinoma patients, which can helpfully estimate the recurrence-free survival. It may be a useful tool for clinician to select optimal candidates for upfront surgery or neoadjuvant therapy.

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Section: Discussionmentioning

confidence: 99%

A predictive model for recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC) by using preoperative clinical data and CT characteristics

et al. 2022

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“…The main issue is that, currently, there is no clinically relevant tool able to accurately stratify patients in terms of early distant relapse (EDR) after upfront surgery. Previously proposed models have limited clinical utility mainly because they consist of pathologic data obtained after surgery and therefore are not applicable in a preoperative setting [ 6 , 9 , 34 , 35 , 36 , 37 , 38 ]; another major limitation is the poor, inhomogeneous selection of the study cohorts [ 6 , 37 , 39 , 40 ]. In the present study we sought to develop a preoperative model to help identify patients with increased risk of EDR after upfront surgery for pancreatic head adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Early Distant Recurrence in Upfront Resectable Pancreatic Adenocarcinoma: A Multidisciplinary, Machine Learning-Based Approach

Palumbo

Mori

Prato

et al. 2021

Cancers

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Despite careful selection, the recurrence rate after upfront surgery for pancreatic adenocarcinoma can be very high. We aimed to construct and validate a model for the prediction of early distant recurrence (<12 months from index surgery) after upfront pancreaticoduodenectomy. After exclusions, 147 patients were retrospectively enrolled. Preoperative clinical and radiological (CT-based) data were systematically evaluated; moreover, 182 radiomics features (RFs) were extracted. Most significant RFs were selected using minimum redundancy, robustness against delineation uncertainty and an original machine learning bootstrap-based method. Patients were split into training (n = 94) and validation cohort (n = 53). Multivariable Cox regression analysis was first applied on the training cohort; the resulting prognostic index was then tested in the validation cohort. Clinical (serum level of CA19.9), radiological (necrosis), and radiomic (SurfAreaToVolumeRatio) features were significantly associated with the early resurge of distant recurrence. The model combining these three variables performed well in the training cohort (p = 0.0015,HR = 3.58,95%CI = 1.98–6.71) and was then confirmed in the validation cohort (p = 0.0178,HR = 5.06,95%CI = 1.75–14.58). The comparison of survival curves between low and high-risk patients showed a p-value <0.0001. Our model may help to better define resectability status, thus providing an actual aid for pancreatic adenocarcinoma patients’ management (upfront surgery vs. neoadjuvant chemotherapy). Independent validations are warranted.

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“…Já para os tumores localizados no corpo e cauda do pâncreas a cirurgia proposta é a pancreatectomia corpo-caudal. (84) Associada a ressecção do tumor primário está indicada a linfadenectomia das cadeias ganglionares localizadas à direita do ligamento hepato-duodenal, cadeias anteriores e posteriores ao pâncreas, àquelas localizadas à direita da artéria mesentérica superior e a cadeia da região anterior à artéria hepática comum. A extensão da ressecção linfonodal contribui para reduzir o risco de metástases por disseminação sanguínea e linfática e traz informações prognósticas quanto a presença de invasão tumoral, número e localização dos gânglios acometidos, entretanto, sem agregar ganho em termos de sobrevida.…”

Section: Smad4unclassified

Análise da efetividade e toxicidades da quimioterapia adjuvante no adenocarcinoma de pâncreas: estudo de mundo real realizado em um hospital terciário do Sistema Único de Saúde

Trevisan¹

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Aos meus pais, Margareth Alves Pereira e Ricardo César Silva Pereira, por terem depositado confiança em mim e terem me apoiado em todos os momentos que precisei.À minha filha, Celina Alves Trevisan, que é minha fonte inigualável de amor sempre tornando meus dias mais alegres.Ao meu marido, Cristian Anselmo Trevisan, por estar ao meu lado durante toda essa trajetória, dando o suporte emocional necessário para enfrentar todos os desafios.À Prof. Dra. Fernanda Maris Peria, que me incentivou a trilhar esse caminho e esteve disponível para todos os momentos. Aos amigos Kaique Ferreira Costa de Almeida e Matheus de Aquino MoreiraGuimarães, que dividiram comigo as angústias e felicidades desse projeto.A todos os meus professores, oncologistas, enfermeiras e técnicas de enfermagem que me ensinaram a oncologia a cada dia durante a residência e na vida profissional.O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) -Código de Financiamento 001.E finalmente, a todos os pacientes e familiares, que permitem que possamos cada vez mais aprender e aprimorar nossos conhecimentos, meu muito obrigada. RESUMOTrevisan AAP. Análise da efetividade e toxicidades da quimioterapia adjuvante no adenocarcinoma de pâncreas: estudo de mundo real realizado em um Hospital

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Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer

Cited by 3 publications

References 0 publications

A predictive model for recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC) by using preoperative clinical data and CT characteristics

A predictive model for recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC) by using preoperative clinical data and CT characteristics

Prediction of Early Distant Recurrence in Upfront Resectable Pancreatic Adenocarcinoma: A Multidisciplinary, Machine Learning-Based Approach

Análise da efetividade e toxicidades da quimioterapia adjuvante no adenocarcinoma de pâncreas: estudo de mundo real realizado em um hospital terciário do Sistema Único de Saúde

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