Wu JY, Wang YF, Ma H, Li SS, Miao HL. Nomograms predicting long-term survival in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: A population-based study. World J Gastroenterol 2020; 26(5): 535-549 [PMID: 32089629 DOI: 10.3748/wjg.v26.i5.535]
Corresponding Author of This Article
Hui-Lai Miao, MD, Professor, Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, No. 57 South of Renmin Avenue, Zhanjiang 524001, Guangdong Province, China. 627225370@qq.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
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Wu JY, Wang YF, Ma H, Li SS, Miao HL. Nomograms predicting long-term survival in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: A population-based study. World J Gastroenterol 2020; 26(5): 535-549 [PMID: 32089629 DOI: 10.3748/wjg.v26.i5.535]
Jia-Yuan Wu, Hui-Lai Miao, Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
Yu-Feng Wang, Huan Ma, Sha-Sha Li, School of Public Health, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
Hui-Lai Miao, Department of Hepatobiliary Surgery, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
Hui-Lai Miao, Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangdong Medical University, Zhanjiang 524003, Guangdong Province, China
Author contributions: Wu JY and Wang YF contributed equally to this work. All authors helped to performed the research; Wu JY contributed to manuscript writing, data extraction, and data analysis; Wang YF contributed to manuscript writing, drafting, conception and design; Ma H contributed to manuscript writing, data collection, and statistical analysis; Li SS contributed to manuscript writing, statistical software, and data analysis; Miao HL contributed to study design, manuscript writing, drafting, conception and design.
Supported byNational Natural Science Foundation of China, No. 81702270; the Natural Science Foundation of Guangdong, No. 2015A030313827; The Affiliated Hospital of Guangdong Medical University Clinical Research Program, No. LCYJ2018C012.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Guangdong Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because this study used a public database with anonymous clinical data and the patients’ personal privacy information was not available.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: The relevant data in this study can be obtained in the SEER database.
Corresponding author: Hui-Lai Miao, MD, Professor, Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, No. 57 South of Renmin Avenue, Zhanjiang 524001, Guangdong Province, China. 627225370@qq.com
Received: November 7, 2019 Peer-review started: November 7, 2019 First decision: December 7, 2019 Revised: January 6, 2020 Accepted: January 11, 2020 Article in press: January 11, 2020 Published online: February 7, 2020 Processing time: 91 Days and 21.8 Hours
ARTICLE HIGHLIGHTS
Research background
Patients with invasive intraductal papillary mucinous neoplasms (IPMNs) of the pancreas after resection have a distinct unfavorable prognosis. Clinicians need an effective prognostic tool to predict the survival probability of individual patients and to plan further clinical management. To date, no previous study has focused on a predictive model for the prognosis of IPMNs.
Research motivation
Considering the rarity and the indolent course of IPMNs, it is difficult to develop a prognostic nomogram for IPMNs in a single institution. Thus, a prognostic nomogram should be performed based on a population-based cohort with long-term follow-up to achieve the best conclusion. The Surveillance, Epidemiology, and End Results database has provided useful data on prognosis in patients with IPMNs.
Research objectives
We aimed to develop and validate comprehensive nomograms to estimate the probability of long-term overall survival and cancer-specific survival in individual patients with invasive IPMNs of the pancreas who underwent surgical resection.
Research methods
The information on patients with invasive IPMNs after resection was extracted from the Surveillance, Epidemiology, and End Results database, and then randomly divided into the training and the validation cohorts (roughly 7:3). Based on the Cox regression model, nomograms were constructed to predict the probability of overall survival and cancer-specific survival at different time points for an individual patient. The performance of the nomogram was measured with respect to discrimination, calibration, and clinical utility. Moreover, we compared the predictive accuracy of the nomograms with that of the traditional staging system.
Research results
In the training cohort, age, marital status, histological type, T stage, N stage, M stage, and chemotherapy were selected to construct nomograms. Compared to the American Joint Committee on Cancer 7th staging system, the formulated nomograms in this study showed perfect performance with respect to discrimination, calibration, reclassification, and clinical usefulness.
Research conclusions
The nomograms showed improved predictive accuracy, discrimination capability, and clinical utility.
Research perspectives
These new predictive models need to be validated by a prospective study or at least in another dataset.
