Risk factors, prognostic factors, and nomograms for distant metastasis in patients with diagnosed duodenal cancer: A population-based study

Table 1 Baseline clinical characteristics of duodenal cancer patients, n (%)

	Training (%) (n = 1822)	Validation (n = 781)	Overall (n = 2603)	χ2	P value
Age, yr				0.125	0.939
< 60	625 (34.3)	266 (34.1)	891 (34.2)
> 70	645 (35.4)	282 (36.1)	927 (35.6)
60-70	552 (30.3)	233 (29.8)	785 (30.2)
Race				2.1543	0.3406
Black	358 (19.6)	142 (18.2)	500 (19.2)
Other	166 (9.1)	84 (10.8)	250 (9.6)
White	1298 (71.2)	555 (71.1)	1853 (71.2)
Sex				1.795	0.180
Female	863 (47.4)	393 (50.3)	1256 (48.3)
Male	959 (52.6)	388 (49.7)	1347 (51.7)
Marital status				0.003	0.955
Married	1095 (60.1)	471 (60.3)	1566 (60.2)
Single	727 (39.9)	310 (39.7)	1037 (39.8)
Income				3.034	0.219
$50000- $70000	844 (46.3)	377 (48.3)	1221 (46.9)
< $50000	294 (16.1)	138 (17.7)	432 (16.6)
> $70000	684 (37.5)	266 (34.1)	950 (36.5)
PRCDA				0.635	0.426
No	1338 (73.4)	561 (71.8)	1899 (73.0)
Yes	484 (26.6)	220 (28.2)	704 (27.0)
T				0.092	0.761
T1-T2	943 (51.8)	410 (52.5)	1353 (52.0)
T3-T4	879 (48.2)	371 (47.5)	1250 (48.0)
N				0.160	0.689
N0	1190 (65.3)	503 (64.4)	1693 (65.0)
N1-N2	632 (34.7)	278 (35.6)	910 (35.0)
Grade				1.132	0.568
I	790 (43.3)	354 (45.3)	1144 (43.9)
II	528 (29.0)	212 (27.1)	740 (28.4)
III-IV	504 (27.7)	215 (27.5)	719 (27.6)
Tumor size, mm				0.018	0.894
< 25	868 (47.6)	375 (48.0)	1243 (47.8)
≥ 25	954 (52.4)	406 (52.0)	1360 (52.2)
Histological type				0.010	0.995
Adenocarcinoma	652 (35.8)	281 (36.0)	933 (35.8)
Carcinoid tumor	661 (36.3)	282 (36.1)	943 (36.2)
Other	509 (27.9)	218 (27.9)	727 (27.9

PRCDA: Purchased Referred Care Delivery Area.

Table 2 Univariate and multivariate logistic analyses of distant metastasis in duodenal cancer patients

	Univariate analysis			Multivariate analysis
	OR	95%CI	P value	OR	95%CI	P value
Age, yr
< 60	Reference
60-70	1.164	0.939-1.445	0.246
> 70	1.266	1.032-1.554	0.058
Race
Black	Reference
White	1.013	0.817-1.265	0.92
Other	1.014	0.722-1.413	0.946
Sex
Female	Reference			Reference
Male	1.245	1.050-1.477	0.035	1.165	0.965-1.408	0.183
Marital status
Married	Reference
Single	1.056	0.888-1.254	0.603
Income
$50000-$70000	Reference
< $50000	0.789	0.603-1.021	0.137
> $70000	1.279	1.065-1.536	0.027
PRCDA
No	Reference
Yes	1.118	0.925-1.347	0.330
T
T1-T2	Reference			Reference
T3-T4	5.926	4.832-7.316	< 0.001	1.779	1.360-2.336	< 0.001
N
N0	Reference			Reference
N1-N2	2.719	2.289-3.233	< 0.001	1.306	1.070-1.595	0.027
Grade
I	Reference			Reference
II	4.119	3.072-5.579	< 0.001	2.174	1.560-3.053	< 0.001
III-IV	16.616	12.710-22.039	< 0.001	7.819	5.689-10.870	< 0.001
Tumor size, mm
< 25	Reference			Reference
≥ 25	5.976	4.822-7.469	< 0.001	1.649	1.249-2.186	0.003
Histological type
Adenocarcinoma	Reference
Carcinoid tumor	0.106	0.078-0.142	< 0.001
Other	0.740	0.612-0.894	0.009

PRCDA: Purchased Referred Care Delivery Area.

Table 3 Baseline clinical characteristics of patients diagnosed duodenal cancer with distant metastasis, n (%)

	Training (%) (n = 319)	Validation (n = 138)	Overall (n = 457)	χ2	P value
Age, yr				0.839	0.657
< 60	94 (29.5)	46 (33.3)	140 (30.6)
> 70	124 (38.9)	53 (38.4)	177 (38.7)
60-70	101 (31.7)	39 (28.3)	140 (30.6)
Race				0.351	0.839
Black	61 (19.1)	26 (18.8)	87 (19.0)
Other	29 (9.1)	15 (10.9)	44 (9.6)
White	229 (71.8)	97 (70.3)	326 (71.3)
Sex				1.010	0.315
Female	145 (45.5)	55 (39.9)	200 (43.8)
Male	174 (54.5)	83 (60.1)	257 (56.2)
Marital status				0.046	0.831
Married	190 (59.6)	80 (58.0)	270 (59.1)
Single	129 (40.4)	58 (42.0)	187 (40.9)
Income				1.765	0.414
$50000-$70000	147 (46.1)	57 (41.3)	204 (44.6)
< $50000	43 (13.5)	16 (11.6)	59 (12.9)
> $70000	129 (40.4)	65 (47.1)	194 (42.5)
PRCDA				2.04420	0.153
No	220 (69.0)	105 (76.1)	325 (71.1)
Yes	99 (31.0)	33 (23.9)	132 (28.9)
T				0.4560	0.500
T1-T2	59 (18.5)	30 (21.7)	89 (19.5)
T3-T4	260 (81.5)	108 (78.3)	368 (80.5)
N				0.043	0.837
N0	146 (45.8)	61 (44.2)	207 (45.3)
N1-N2	173 (54.2)	77 (55.8)	250 (54.7)
Surgery				0.468	0.494
No	238 (74.6)	98 (71.0)	336 (73.5)
Yes	81 (25.4)	40 (29.0)	121 (26.5)
Chemotherapy				0.324	0.569
No	144 (45.1)	67 (48.6)	211 (46.2)
Yes	175 (54.9)	71 (51.4)	246 (53.8)
Radiation				0.192	0.661
No	278 (87.1)	123 (89.1)	401 (87.7)
Yes	41 (12.9)	15 (10.9)	56 (12.3)
Grade				0.613	0.736
I	35 (11.0)	12 (8.7)	47 (10.3)
II	78 (24.5)	33 (23.9)	111 (24.3)
III-IV	206 (64.6)	93 (67.4)	299 (65.4)
Tumor size, mm				0.157	0.692
< 25	55 (17.2)	21 (15.2)	76 (16.6)
25	264 (82.8)	117 (84.8)	381 (83.4)
Histology				0.506	0.776
Adenocarcinoma	181 (56.7)	78 (56.5)	259 (56.7)
Carcinoid tumor	24 (7.5)	13 (9.4)	37 (8.1)
Other	114 (35.7)	47 (34.1)	161 (35.2)
Lung				3.109	0.0779
No	290 (90.9)	117 (84.8)	407 (89.1)
Yes	29 (9.1)	21 (15.2)	50 (10.9)
Bone				0.072	0.788
No	304 (95.3)	133 (96.4)	437 (95.6)
Yes	15 (4.7)	5 (3.6)	20 (4.4)
Brain				0.588	2.326
No	317 (99.4)	136 (98.6)	453 (99.1)
Yes	2 (0.6)	2 (1.4)	4 (0.9)
Liver				0.315	0.575
No	56 (17.6)	28 (20.3)	84 (18.4)
Yes	263 (82.4)	110 (79.7)	373 (81.6)

PRCDA: Purchased Referred Care Delivery Area.

Table 4 Univariate and multivariate Cox analyses in duodenal cancer patients with distant metastasis

	Univariate analysis			Multivariate analysis
	HR	95%CI	P value	HR	95%CI	P value
Age, yr
< 60	Reference			Reference
60-70	1.768	1.379-2.265	< 0.001	1.648	1.280-2.123	< 0.001
> 70	2.276	1.793-2.891	< 0.001	1.848	1.450-2.356	0.002
Race
Black	Reference
White	1.042	0.825-1.316	0.771
Other	0.702	0.467-1.054	0.152
Sex
Female	Reference
Male	1.216	1.001-1.478	0.098
Marital status
Married	Reference
Single	1.267	1.045-1.536-	0.044
Income
$50000-$70000	Reference
< $50000	1.127	0.851-1.493	0.484
> $70000	0.841	0.684-1.034	0.169
PRCDA
No	Reference
Yes	0.981	0.796-1.210	0.882
T
T1-T2	Reference			Reference
T3-T4	1.814	1.384-2.376	< 0.001	1.481	1.126-1.947	0.018
N
N0	Reference
N1-N2	1.078	0.890-1.307	0.519
Grade
I	Reference
II	2.805	1.840-4.276	< 0.001	2.833	1.827-4.394	< 0.001
III-IV	3.642	2.442-5.432	< 0.001	3.083	2.030-4.682	< 0.001
Tumor size, mm
< 25	Reference
≥ 25	1.870	1.415-2.470	< 0.001	1.410	1.055- 1.884	0.051
Histological type
Adenocarcinoma	Reference
Carcinoid tumor	0.146	0.083-0.257	< 0.001	0.163	0.088-0.300	< 0.001
Other	0.471	0.379-0.586	< 0.001	0.567	0.450-0.713	< 0.001
Surgery
No
Yes	0.361	0.285-0.456	< 0.001	0.455	0.357 -0.581	< 0.001
Chemotherapy
No
Yes	0.767	0.631- 0.931	0.024	0.6004	0.491-0.734	< 0.001
Radiation
No
Yes	1.232	0.944-1.608	0.197
Bone
No
Yes	3.094	2.065-4.635	< 0.001	3.239	2.138- 4.908	< 0.001
Liver
No
Yes	1.067	0.844- 1.347	0.650
Brain
No
Yes	1.958	0.854-4.486	0.183
Lung
no
Yes	1.332	0.987-1.797	0.116

HR: Hazard ratio; PRCDA: Purchased Referred Care Delivery Area.