Prognostic value of a nomogram model for pancreatic cancer incorporating the systemic immune-inflammation and prognostic nutritional indices

Table 1 Baseline data

Clinicopathologic factors	Total number (n = 164)	Training cohort (n = 129)	External validation cohort (n = 35)	P value
Gender				0.022a
Male	89 (54.3)	76 (58.9)	13 (37.1)
Female	75 (45.7)	53 (41.1)	22 (62.9)
Age (years)				0.624
≤ 65	81 (49.4)	65 (50.4)	19 (54.3)
> 65	83 (50.6)	64 (49.6)	16 (45.7)
Underlying diseases				0.341
No	82 (50)	67 (51.9)	15 (42.9)
Yes	82 (50)	62 (48.1)	20 (57.1)
Surgical method				< 0.001a
Endoscopic surgery	32 (19.5)	16 (12.4)	16 (45.7)
Open surgery	132 (80.5)	113 (87.6)	19 (54.3)
Tumor location				0.804
Pancreatic body/tail	58 (35.4)	45 (34.9)	13 (37.1)
Pancreatic head	106 (64.6)	84 (65.1)	22 (62.9)
Tumor maximum diameter (cm)				0.301
≤ 3	81 (49.6)	61 (47.3)	20 (57.1)
> 3	83 (50.6)	68 (52.7)	15 (42.9)
T staging				0.543
T1-T2	120 (73.2)	93 (72.1)	27 (77.1)
T3-T4	42 (26.9)	36 (27.9)	8 (22.9)
N grouping				0.192
N0	100 (61.0)	82 (63.6)	18 (51.4)
N1-N2	64 (39.0)	47 (36.4)	17 (48.6)
TNM staging				0.771
I-II	144 (87.8)	114 (88.4)	30 (85.7)
III	20 (12.2)	15 (11.6)	5 (14.3)
Degree of tumor differentiation				0.871
Moderately or well-differentiated	105 (64.0)	83 (64.3)	22 (62.9)
Poorly differentiated	59 (36.0)	46 (35.7)	13 (37.1)
Surgical margins				0.343
Negative	158 (96.3)	123 (95.3)	35 (100.0)
Positive	6 (3.7)	6 (4.65)	0 (0.0)
Vascular tumor thrombus				0.072
No	81 (49.4)	59 (45.7)	22 (62.9)
Yes	83 (50.6)	70 (54.3)	13 (37.1)
Vascular/nerve invasion				0.381
No	20 (12.2)	14 (10.9)	6 (17.1)
Yes	144 (87.8)	115 (89.1)	29 (82.9)
Lymph node metastasis				0.139
No	102 (62.2)	84 (65.1)	18 (51.4)
Yes	62 (37.8)	45 (34.9)	17 (48.6)
Postoperative adjuvant chemotherapy				0.847
No	110 (67.1)	42 (32.6)	12 (34.3)
Yes	54 (32.9)	87 (67.4)	23 (65.7)
Recent postoperative complications				0.960
No	126 (76.8)	99 (76.7)	27 (77.1)
Yes	38 (23.2)	30 (23.3)	8 (22.9)
CEA (ng/mL)				0.322
≤ 5	123 (75.0)	99 (76.7)	24 (68.6)
> 5	41 (25.0)	30 (23.3)	11 (31.4)
CA19-9 (U/mL)				0.274
≤ 37	40 (24.4)	29 (22.5)	11 (31.4)
> 37	124 (75.6)	100 (77.5)	24 (68.6)
SII				0.011a
≤ 335.82	58 (35.4)	52 (40.3)	6 (17.1)
> 335.82	106 (64.6)	77 (59.7)	29 (82.9)
PNI				0.331
≤ 44.45	68 (41.5)	56 (43.4)	12 (34.3)
> 44.45	96 (58.5)	73 (56.6)	23 (65.7)

^aP < 0.05.

Data are presented as n (%). TNM: Tumor-node-metastasis; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; SII: Systemic immune inflammation index; PNI: Prognostic nutritional index.

Table 2 Univariable and multivariable Cox regression analyses for the prognosis of pancreatic ductal adenocarcinoma patients

Clinicopathologic factors	Univariable analysis		P value	Multivariable analysis		P value
	HR	95%CI		HR	95%CI
Gender
Female	1 (reference)		-	-	-	-
Male	0.955	0.634-1.438	0.824	-	-	-
Age (years)
≤ 65	1 (reference)		-	-	-	-
> 65	1.107	0.736-1.665	0.626	-	-	-
Underlying diseases
No	1 (reference)		-	-	-	-
Yes	0.992	0.661-1.491	0.970	-	-	-
Surgical methods
Endoscopic surgery	1 (reference)		-	-	-	-
Open surgery	1.101	0.570-2.128	0.774	-	-	-
Tumor location
Pancreatic body/tail	1 (reference)		-	-	-	-
Pancreatic head	0.754	0.495-1.147	0.187	-	-	-
Tumor maximum diameter (cm)
≤ 3	1 (reference)		-	-	-	-
> 3	1.816	1.194-2.762	0.005a	1.592	0.962-2.633	0.070
T staging
T1-T2	1 (reference)	-	-	-	-	-
T3-T4	1.568	1.013-2.427	0.043a	1.061	0.624-1.802	0.827
N grouping
N0	1 (reference)	-	-	-	-	-
N1-N2	1.325	0.877-2.002	0.181	-		-
TNM staging
I-II	1 (reference)	-	-	-	-	-
III	1.129	0.601-2.120	0.707	-	-	-
Degree of tumor differentiation
Moderately or well-differentiated	1 (reference)	-	-	-	-	-
Poorly differentiated	1.607	1.057-2.442	0.026a	1.614	1.036-2.515	0.034a
Surgical margins
Negative	1 (reference)	-	-	-	-	-
Positive	1.033	0.451-2.371	0.938	-	-	-
Vascular tumor thrombus
No	1 (reference)	-	-	-	-	-
Yes	1.058	0.700-1.599	0.790	-	-	-
Vascular/nerve invasion
No	1 (reference)	-	-	-	-	-
Yes	1.715	0.859-3.426	0.126	-	-	-
Lymph node metastasis
No	1 (reference)	-	-	-	-	-
Yes	1.251	0.825-1.897	0.292	-	-	-
Postoperative adjuvant chemotherapy
No	1 (reference)	-	-	-	-	-
Yes	0.575	0.373-0.885	0.012a	0.561	0.360-0.874	0.011a
Recent postoperative complications
No	1 (reference)	-	-	-	-	-
Yes	1.218	0.763-1.945	0.408	-	-	-
CEA (ng/mL)
≤ 5	1 (reference)	-	-	-	-	-
> 5	0.917	0.562-1.495	0.728	-	-	-
CA19-9 (U/mL)
≤ 37	1 (reference)	-	-	-	-	-
> 37	2.021	1.142-3.576	0.016a	1.844	1.021-3.330	0.043a
SII
≤ 335.82	1 (reference)	-	-	-	-	-
> 335.82	1.844	1.194-2.849	0.006a	1.891	1.217-2.938	0.005a
PNI
≤ 44.45	1 (reference)	-	-	-	-	-
> 44.45	1.990	1.305-3.034	0.001a	2.149	1.381-3.343	0.001a

^aP < 0.05.

HR: Hazard ratio; CI: Confidence interval; TNM: Tumor-node-metastasis; SII: Systemic immune inflammation index; PNI: Prognostic nutritional index; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9.