Nomogram construction based on SEER and survival prediction of pancreatic cancer patients

doi:10.16139/j.1007-9610.2024.01.08

Abstract

Abstract:

Objective To analyze the independent factors affecting the prognosis of pancreatic cancer and construct a prediction model based on surveillance, epidemiology, and end results (SEER) database. Methods The clinical data of 7 801 American pancreatic cancer patients from 2010 to 2015 were obtained from SEER database. They were randomly divided into training group and validation group in a ratio of 7:3. The nomogram was constructed after multivariate COX regression analysis of clinical variables in the training group. The accuracy of the model was verified by receiver operating characteristic(ROC) curve and calibration curve. Results Age, primary-site, grade, T-stage, N-stage, M-stage，surgery, radiotherapy and chemotherapy were related to the prognosis of the patients with pancreatic cancer. The area under curve(AUC) of overall survival(OS) ROC curve of 3- and 5-year were 0.90 and 0.91 respectively. The AUC of cancer specific survival(CSS) ROC curve were 0.91 and 0.91 respectively. The calibration curve showed a good consistency between the observed and predicted values. The selected clinical variables did have an impact on the prognosis of the patients with pancreatic cancer. Conclusions The model had good prediction accuracy and was helpful for clinical decision-making and personalized treatment of the patients with pancreatic cancer.

Key words: Pancreatic cancer, Surveillance, epidemiology, and end results (SEER), Cancer specific survival rate, Overall survival rate, Nomogram

CLC Number:

R735.9

LU Zhongxiao, TANG Jie, HUANG Wenhai. Nomogram construction based on SEER and survival prediction of pancreatic cancer patients[J]. Journal of Surgery Concepts & Practice, 2024, 29(01): 46-53.

Figures/Tables 7

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Variables	Total (n=7 801)	Training group (n=5 461)	Validation group (n=2 340)	P value
Age				0.41
<65	3 122(40.02)	2 169(39.72)	953(40.73)
≥65	4 679(59.98)	3 292(60.28)	1387(59.27)
Race				0.58
White	6 130(78.58)	4 294(78.63)	1 836(78.46)
African descent	1 003(12.86)	691(12.65)	312(13.33)
Other	668(8.56)	476(8.72)	192(8.21)
Sex				0.88
Male	4 094(52.48)	2 863(52.43)	1 231(52.61)
Female	3 707(47.52)	2 598(47.57)	1 109(47.39)
Primary site				0.67
Head	4 043(51.83)	2 839(51.99)	1 204(51.45)
Body and tail	3 758(48.17)	2 622(48.01)	1 136(48.55)
Grade				0.29
Ⅰ+Ⅱ	4 608(59.07)	3 247(59.46)	1 361(58.16)
Ⅲ+Ⅳ	3 193(40.93)	2 214(40.54)	979(41.84)
T stage				0.42
T1+T2	2 766(35.46)	1 952(35.74)	814(34.79)
T3+T4	5 035(64.54)	3 509(64.26)	1 526(65.21)
N stage				0.60
N0	4 993(64.00)	3 485(63.82)	1 508(64.44)
N1	2 808(36.00)	1 976(36.18)	832(35.56)
M stage				0.12
M0	4 749(60.88)	3 294(60.32)	1 455(62.18)
M1	3 052(39.12)	2 167(39.68)	885(37.82)
Surgery				0.70
No	5 505(70.57)	3 862(70.72)	1 643(70.22)
Palliative	67(0.86)	44(0.81)	23(0.98)
Radical	2 229(28.57)	1 555(28.47)	674(28.80)
Radiotherapy				0.20
No	2 296(29.43)	1 631(29.87)	665(28.42)
Yes	5 505(70.57)	3 830(70.13)	1 675(71.58)
Chemotherapy				>0.05
No	584(7.49)	428(7.84)	156(6.67)
Yes	7 217(92.51)	5 033(92.16)	2 184(93.33)

Variables	HR(95%CI)	β value	P value
Age(years)
<65	-	-	-
≥65	1.55（1.46-1.65）	0.44	<0.001
Race
White	-	-	-
African descent	1.10（1.02-1.20）	0.10	0.02
Other	0.96（0.87-1.06）	-0.04	0.40
Gender
Male	-	-	-
Female	0.98（0.93-1.03）	-0.02	0.39
Primary site
Head	-	-	-
Body and tail	1.12（1.05-1.19）	0.11	<0.001
Grade
Ⅰ+Ⅱ	-	-	-
Ⅲ+Ⅳ	1.70（1.61-1.80）	0.53	<0.001
T stage
T1+T2	-	-	-
T3+T4	1.27（1.19-1.35）	0.24	<0.001
N stage
N0	-	-	-
N1	1.09（1.03-1.16）	0.09	<0.01
M stage
M0	-	-	-
M1	1.29（1.17-1.42）	0.25	<0.001
Surgery
No	-	-	-
Palliative	0.26（0.24-0.29）	-1.33	<0.001
Radical	0.21（0.14-0.32）	-1.57	<0.001
Radiotherapy
No	-	-
Yes	0.82（0.75-0.90）	-0.20	<0.001
Chemotherapy
No	-	-
Yes	0.81（0.73-0.89）	-0.21	<0.001

Variables	HR(95%CI)	β value	P value
Age(years)
<65	-	-	-
≥65	1.58（1.47-1.69）	0.46	<0.001
Race
White	-	-	-
African descent	1.11（1.01-1.22）	0.10	0.03
Other	0.94（0.83-1.06）	-0.06	0.30
Gender
Male	-	-	-
Female	0.99（0.93-1.06）	-0.01	0.85
Primary site
Head	-	-	-
Body and tail	1.16（1.08-1.25）	0.15	<0.001
Grade
Ⅰ+Ⅱ	-	-	-
Ⅲ+Ⅳ	1.70（1.59-1.82）	0.53	<0.001
T stage
T1+T2	-	-	-
T3+T4	1.30（1.21-1.40）	0.27	<0.001
N stage
N0	-	-	-
N1	1.11（1.03-1.19）	0.10	<0.01
M stage
M0	-	-	-
M1	1.34（1.20-1.50）	0.29	<0.001
Surgery
No	-	-	-
Palliative	0.27（0.24-0.30）	-1.30	<0.001
Radical	0.20（0.12-0.35）	-1.59	<0.001
Radiotherapy
No	-	-
Yes	0.84（0.75-0.94）	-0.18	<0.01
Chemotherapy
No	-	-
Yes	0.81（0.72-0.91）	-0.21	<0.001