This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Validation of a nomogram for predicting survival after resection for adenocarcinoma of the pancreas. BJS 2009; 96: 417-423.
Published: 12th March 2009
Authors: S. M. M. de Castro, S. S. A. Y. Biere, S. M. Lagarde, O. R. C. Busch, T. M. van Gulik, D. J. Gouma et al.
Background
Nomograms are statistical tools providing the overall probability of a specific outcome; they have shown better individual discrimination than the tumour node metastasis staging system in several cancers. The pancreatic nomogram, originally developed in the Memorial Sloan–Kettering Cancer Center (MSKCC) in the USA, combines clinicopathological and operative data to predict disease‐specific survival at 1, 2 and 3 years from initial resection.
Method
An external patient cohort from a retrospective pancreatic adenocarcinoma database at the Academic Medical Centre in Amsterdam was used to test the validity of the pancreatic adenocarcinoma nomogram. The cohort included 263 consecutive patients who had surgery between January 1985 and December 2004.
Results
Data for all the necessary variables were available for 256 patients (97·3 per cent). At the last follow‐up, 35 patients were alive, with a median follow‐up of 27 (range 3–114) months. The 1‐, 2‐ and 3‐year disease‐specific survival rates were 60·8, 30·4 and 16·0 per cent respectively. The nomogram concordance index was 0·61. The calibration analysis of the model showed that the predicted survival did not significantly deviate from the actual survival.
Conclusion
The MSKCC pancreatic cancer nomogram provided an accurate survival prediction. It may aid in counselling patients and in stratification of patients for clinical trials. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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