Development and External Validation of Survival Prediction Model for Pancreatic Cancer Using Two Nationwide Databases: Surveillance, Epidemiology and End Results (SEER) and Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP).

Abstract

Background/Aims:

Several prediction models for evaluating the prognosis of nonmetastatic resected pancreatic ductal adenocarcinoma (PDAC) have been developed, and their performances were reported to be superior to that of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. We developed a prediction model to evaluate the prognosis of resected PDAC and externally validated it with data from a nationwide Korean database.

Methods:

Data from the Surveillance, Epidemiology and End Results (SEER) database were utilized for model development, and data from the Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP) database were used for external validation. Potential candidate variables for model development were age, sex, histologic differentiation, tumor location, adjuvant chemotherapy, and the AJCC 8th staging system T and N stages. For external validation, the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC) were evaluated.

Results:

Between 2004 and 2016, data from 9,624 patients were utilized for model development, and data from 3,282 patients were used for external validation. In the multivariate Cox proportional hazard model, age, sex, tumor location, T and N stages, histologic differentiation, and adjuvant chemotherapy were independent prognostic factors for resected PDAC. After an exhaustive search and 10-fold cross validation, the best model was finally developed, which included all prognostic variables. The C-index, 1-year, 2-year, 3-year, and 5-year time-dependent AUCs were 0.628, 0.650, 0.665, 0.675, and 0.686, respectively.

Conclusions:

The survival prediction model for resected PDAC could provide quantitative survival probabilities with reliable performance. External validation studies with other nationwide databases are needed to evaluate the performance of this model.

• Authors: Jae Seung Kang, Lydia Mok, Jin Seok Heo, In Woong Han, Sang Hyun Shin, Yoo-Seok Yoon, Ho-Seong Han, Dae Wook Hwang, Jae Hoon Lee, Woo Jung Lee, Sang Jae Park, Joon Seong Park, Yonghoon Kim, Huisong Lee, Young-Dong Yu, Jae Do Yang, Seung Eun Lee, Il Young Park, Chi-Young Jeong, Younghoon Roh, Seong-Ryong Kim, Ju Ik Moon, Sang Kuon Lee, Hee Joon Kim, Seungyeoun Lee, Hongbeom Kim, Wooil Kwon, Chang-Sup Lim, Jin-Young Jang, Taesung Park
• Journal: Gut and liver (Gut Liver) Vol. 15 Issue 6 Pg. 912-921 (11 15 2021) ISSN: 2005-1212 [Electronic] Korea (South)
• PMID: 33941710 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Carcinoma, Pancreatic Ductal (pathology)
• Humans
• Neoplasm Staging
• Pancreas (pathology)
• Pancreatic Neoplasms (epidemiology, pathology)
• Prognosis
• Registries
• Republic of Korea (epidemiology)