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KMID : 1188320210150060912
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Gut and Liver
2021 Volume.15 No. 6 p.912 ~ p.921
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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)
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Kang Jae-Seung
Mok Lydia
Heo Jin-Seok
Han In-Woong
Shin Sang-Hyun
Yoon Yoo-Seok
Han Ho-Seong
Hwang Dae-Wook
Lee Jae-Hoon
Lee Woo-Jung
Park Sang-Jae
Park Joon-Seong
Kim Yong-Hoon
Lee Hui-Song
Yu Young-Dong
Yang Jae-Do
Lee Seung-Eun
Park Il-Young
Jeong Chi-Young
Roh Young-Hoon
Kim Seong-Ryong
Moon Ju-Ik
Lee Sang-Kuon
Kim Hee-Joon
Lee Seung-Yeoun
Kim Hong-Beom
Kwon Woo-Il
Lim Chang-Sup
Jang Jin-Young
Park Tae-Sung
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Abstract
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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.
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KEYWORD
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Pancreatic neoplasms, Survival, Prognosis
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