Tumor grade as significant prognostic factor in pancreatic cancer: validation of a novel TNMG staging system

Hlavsa, Jan; Čečka, Filip; Záruba, Pavel; Zajak, J; Gürlich, R; Strnad, R; Pavlík, Tomáš; Kala, Zdeněk; Loveček, Martin

doi:10.4149/neo_2018_171012n650

Cited by 17 publications

(16 citation statements)

References 17 publications

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“…In addition, since patients with T4 stage tumors may not be able to undergo surgery, patients with T4 stage pancreatic adenocarcinoma were not included in the study. Consistent with previous findings, the results of the present study demonstrated that, in addition to the T and N stages, tumor grade may also act as an independent predictor for patients with resected pancreatic adenocarcinoma (14,31,37). For example, it has been reported that well-differentiated tumors are significantly associated with longer survival rates (14,37,38).…”

Section: Discussionsupporting

confidence: 92%

“…The nomogram developed in the present study demonstrated the magnitude of poor prognosis as tumor grade changed from well to poorly differentiated. It has been reported that tumor grade incorporation into the current TNM system enables accurate prognosis prediction within particular clinical stages (30), which has been validated by two subsequent studies (11,37). In the present study, patients with distinct tumor grades were assigned to different points in the nomogram, even if they were classified within the same TNM stage.…”

Section: Discussionmentioning

confidence: 61%

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Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

Ren

Aimaiti

et al. 2020

Oncol Lett

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The survival prediction for patients with resected pancreatic adenocarcinoma by using the Tumor-Node-Metastasis (TNM) staging system remains limited. A nomogram is a efficient tool that can be used to predict the outcome of patients with various types of malignancy. The present study aimed to develop and validate a nomogram for patients with resected pancreatic adenocarcinoma. A total of 368 patients (258 in the training set and 110 in the validation set) who underwent pancreatic adenocarcinoma resection at the China National Cancer Center between January 2008 and October 2018 were included in the present study. The nomogram was established according to the results from Cox multivariate analysis, which was validated by discrimination and calibration. The area under the receiver operating characteristic curve (AUC) was determined to assess the accuracy of survival predictions. The results from multivariate analysis in the training set demonstrated that blood transfusion, T-stage, N-stage, tumor grade, capsule invasion, carbohydrate antigen 199, neutrophil percentage and adjuvant therapy were independent prognostic factors for overall survival (OS; all P<0.05). Subsequently, a nomogram predicting the 1-year, 3-year and 5-year OS rates, with favorable calibration, was established based on the independent prognostic factors. The concordance indices of the nomogram were higher compared with the TNM staging system in both training and validation sets. Furthermore, a clear risk stratification system based on the nomogram was used to classify patients into the three following groups: Low-risk group (≤168), moderate-risk group (168-255) and high-risk group (>255). The risk stratification system demonstrated an improved ability in predicting the 1-year, 3-year and 5-year OS rates compared with the TNM system (AUC, 0.758, 0.709 and 0.672 vs. AUC, 0.614, 0.604 and 0.568; all P<0.05). The present study developed and validated a nomogram for patients with resected pancreatic adenocarcinoma by including additional independent prognostic factors, including tumor marker, immune index, surgical information, pathological data and adjuvant therapy. Taken together, the results from the present study indicated an improved performance of the nomogram in predicting the prognosis of patients with resected pancreatic adenocarcinoma compared with the TNM staging system.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 61%

Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

Ren

Aimaiti

et al. 2020

Oncol Lett

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“…We explored the correlation between JAK2 expression, clinicopathological characteristics, and PDAC patient survival in our hospital in this study. Various clinicopathological features including high serum CA19-9 levels and increased tumor size are significantly correlated with poor OS [ 33 , 34 ]. Consistent with previous studies, the present results showed that tumor differentiation and serum CA19-9 levels were associated with OS.…”

Section: Discussionmentioning

confidence: 99%

High JAK2 Protein Expression Predicts a Poor Prognosis in Patients with Resectable Pancreatic Ductal Adenocarcinoma

et al. 2020

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Background. Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal malignancies worldwide. The JAK/STAT signaling pathway is involved in pancreatic cancer tumorigenesis. However, the prognostic value of JAK2 expression in resectable PDAC is unclear. Method. In this study, we performed a clinicopathological analysis of 62 resectable PDAC cases with a primary focus on survival. JAK2 expression was examined by immunohistochemistry. The relationship between JAK2 expression and clinicopathological features and prognosis was analyzed. Results. Survival curve analyses revealed that high levels of JAK2 expression predict a poor prognosis in resectable PDAC patients. Multivariate analysis confirmed that JAK2 expression can predict the prognosis of PDAC. Conclusions. Assessment of JAK2 protein expression may be a promising method to predict prognosis in patients with resectable PDAC.

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“…In our study, the HR of OS increased with the degree of tumor differentiation decreases, and patients who were welldifferentiation suffered better survival than poor-differentiation patients. Several studies also advised that tumor grade should be incorporated into the current TNM classification, because novel TNMG staging system enables more accurate prognosis prediction within particular clinical stages [18,19].…”

Section: Discussionmentioning

confidence: 99%

Overall survival in patients with metastatic pancreatic cancer after surgically primary tumor resected: a SEER-based nomogram analysis

Pan¹,

Yang²,

Wu³

et al. 2020

Preprint

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Background This study aimed to establish and validate a nomogram to predict overall survival in patients with metastatic pancreatic cancer (mPC) after surgically primary tumor resected. Methods All mPC patients who underwent primary tumor resection at SEER database between 2004 and 2016 were identified. We randomly assigned two-thirds of the patients to the training group and one third to the validation group. In the training group, the Kaplan–Meier survival analysis was used to analyze survival outcomes. A univariate and multivariate cox regression analysis was used to identify significant prognostic factors for establishing a nomogram. The predictive accuracy and discriminative ability were measured by the concordance index (C-index) and risk group stratification. Results A total of 742 patients were included for analysis. Four significant prognostic factors were obtained and included in the nomogram. The nomogram showed an acceptable discrimination ability (C- index:0.711) and good calibration and was further validated in the validation cohort (C- index: 0.727). The nomogram total points (NTP) had the potential to stratify patients into 2-risk groups with a median OS of 11 and 4.5 months (P < 0.001), respectively. Conclusions The nomogram can provide considerable accuracy individual prediction OS outcomes in patients with metastatic pancreatic cancer undergone primary tumor surgery and it can guide clinicians to make decisions in the clinical therapies.

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Tumor grade as significant prognostic factor in pancreatic cancer: validation of a novel TNMG staging system

Cited by 17 publications

References 17 publications

Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

High JAK2 Protein Expression Predicts a Poor Prognosis in Patients with Resectable Pancreatic Ductal Adenocarcinoma

Overall survival in patients with metastatic pancreatic cancer after surgically primary tumor resected: a SEER-based nomogram analysis

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