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Prognostic nomogram and score to predict overall survival in locally advanced untreated pancreatic cancer (PROLAP)
Univ Hosp Besancon, Methodol & Qual Life Oncol Unit, EA 3181, 3 Blvd Alexandre Fleming, F-25030 Besancon, France..
Oncol Multidisciplinary Res Grp GERCOR, 151 Rue Faubourg St Antoine, F-75011 Paris, France.;Tenon Hosp, AP HP, Dept Radiotherapy, 4 Rue Chine, F-75020 Paris, France..
Univ Hosp Besancon, Dept Gastroenterol, 3 Blvd Alexandre Fleming, F-25030 Besancon, France..
Prince Wales Hosp, Dept Med Oncol, Sydney, NSW 2031, Australia.;UNSW, Prince Wales Clin Sch, Sydney, NSW 2031, Australia.;AGITG Australasian Gastrointestinal Trials Grp, 119-143 Missenden Rd, Camperdown, NSW 2050, Australia..
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2016 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 115, no 3, 281-289 p.Article in journal (Refereed) Published
Abstract [en]

Background: The management of locally advanced pancreatic cancer (LAPC) patients remains controversial. Better discrimination for overall survival (OS) at diagnosis is needed. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP).

Methods: Analyses were derived from 442 LAPC patients enrolled in the LAP07 trial. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. Performance assessment and internal validation of the final model were done with Harrell's C-index, calibration plot and bootstrap sample procedures. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besanc, on Hospital, France.

Results: Age, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. The final model had good calibration, acceptable discrimination (C-index = 0.60) and robust internal validity. The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank P<0.0001). The score ability to discriminate OS was externally confirmed in 63 (59%) patients with complete clinical data derived from a data set of 106 consecutive LAPC patients; median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank P<0.0001).

Conclusions: The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future.

Place, publisher, year, edition, pages
2016. Vol. 115, no 3, 281-289 p.
Keyword [en]
prognostic score, nomogram, overall survival, locally advanced pancreatic cancer, chemotherapy
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-302700DOI: 10.1038/bjc.2016.212ISI: 000380380400002PubMedID: 27404456OAI: oai:DiVA.org:uu-302700DiVA: diva2:970928
Available from: 2016-09-15 Created: 2016-09-08 Last updated: 2016-09-15Bibliographically approved

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