Prognostic nomogram for patients with unresectable pancreatic cancer treated with gemcitabine plus nab–paclitaxel or FOLFIRINOX: A post–hoc analysis of a multicenter retrospective study in Japan (NAPOLEON study)

Autor:	Taro Shibuki, Toshihiko Mizuta, Mototsugu Shimokawa, Futa Koga, Yujiro Ueda, Junichi Nakazawa, Azusa Komori, Satoshi Otsu, Shiho Arima, Masaru Fukahori, Akitaka Makiyama, Hiroki Taguchi, Takuya Honda, Kenji Mitsugi, Kenta Nio, Yasushi Ide, Norio Ureshino, Tsuyoshi Shirakawa, Taiga Otsuka
Jazyk:	angličtina
Rok vydání:	2022
Předmět:	unresectable pancreatic cancer nomogram prognosis overall survival chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Zdroj:	BMC Cancer, Vol 22, Iss 1, Pp 1-11 (2022)
Druh dokumentu:	article
ISSN:	1471-2407
DOI:	10.1186/s12885-021-09139-y
Popis:	Abstract Background No reliable nomogram has been developed until date for predicting the survival in patients with unresectable pancreatic cancer undergoing treatment with gemcitabine plus nab–paclitaxel (GnP) or FOLFIRINOX. Methods This analysis was conducted using clinical data of Japanese patients with unresectable pancreatic cancer undergoing GnP or FOLFIRINOX treatment obtained from a multicenter study (NAPOLEON study). A Cox proportional hazards model was used to identify the independent prognostic factors. A nomogram to predict 6–, 12–, and 18–month survival probabilities was generated, validated by using the concordance index (C–index), and calibrated by the bootstrapping method. And then, we attempted risk stratification for survival by classifying the patients according to the sum of the scores on the nomogram (total nomogram points). Results A total of 318 patients were enrolled. A prognostic nomogram was generated using data on the Eastern Cooperative Oncology Group performance status, liver metastasis, serum LDH, serum CRP, and serum CA19–9. The C–indexes of the nomogram were 0.77, 0.72 and 0.70 for 6–, 12–, and 18–month survival, respectively. The calibration plot showed optimal agreement at all points. Risk stratification based on tertiles of the total nomogram points yielded clear separations of the survival curves. The median survival times in the low–, moderate–, and high–risk groups were 15.8, 12.8 and 7.8 months (P
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