Accuracy of models to prognosticate survival after surgery for pancreatic cancer in the era of neoadjuvant therapy

Clayton T Marcinak; William F Parker; Alexander A Parikh; Jashodeep Datta; Shishir K Maithel; David A Kooby; Mark E Burkard; Hong Jin Kim; Michael T LeCompte; Majid Afshar; Matthew M Churpek; Syed Nabeel Zafar

doi:10.1002/jso.27287

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Accuracy of models to prognosticate survival after surgery for pancreatic cancer in the era of neoadjuvant therapy

Journal article

Open access

Peer reviewed

Accuracy of models to prognosticate survival after surgery for pancreatic cancer in the era of neoadjuvant therapy

Clayton T Marcinak, William F Parker, Alexander A Parikh, Jashodeep Datta, Shishir K Maithel, David A Kooby, Mark E Burkard, Hong Jin Kim, Michael T LeCompte, Majid Afshar, …

Journal of surgical oncology, Vol.128(2), pp.280-288

08/2023

DOI: 10.1002/jso.27287

PMCID: PMC10330210

PMID: 37073788

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Abstract

Outcomes for pancreatic adenocarcinoma (PDAC) remain difficult to prognosticate. Multiple models attempt to predict survival following the resection of PDAC, but their utility in the neoadjuvant population is unknown. We aimed to assess their accuracy among patients that received neoadjuvant chemotherapy (NAC). We performed a multi-institutional retrospective analysis of patients who received NAC and underwent resection of PDAC. Two prognostic systems were evaluated: the Memorial Sloan Kettering Cancer Center Pancreatic Adenocarcinoma Nomogram (MSKCCPAN) and the American Joint Committee on Cancer (AJCC) staging system. Discrimination between predicted and actual disease-specific survival was assessed using the Uno C-statistic and Kaplan-Meier method. Calibration of the MSKCCPAN was assessed using the Brier score. A total of 448 patients were included. There were 232 (51.8%) females, and the mean age was 64.1 years (±9.5). Most had AJCC Stage I or II disease (77.7%). For the MSKCCPAN, the Uno C-statistic at 12-, 24-, and 36-month time points was 0.62, 0.63, and 0.62, respectively. The AJCC system demonstrated similarly mediocre discrimination. The Brier score for the MSKCCPAN was 0.15 at 12 months, 0.26 at 24 months, and 0.30 at 36 months, demonstrating modest calibration. Current survival prediction models and staging systems for patients with PDAC undergoing resection after NAC have limited accuracy.

Adenocarcinoma - surgery

Carcinoma, Pancreatic Ductal - drug therapy

Carcinoma, Pancreatic Ductal - surgery

Female

Humans

Male

Middle Aged

Neoadjuvant Therapy

Neoplasm Staging

Nomograms

Pancreatic Neoplasms

Pancreatic Neoplasms - drug therapy

Pancreatic Neoplasms - surgery

Prognosis

Retrospective Studies

Details

Title: Subtitle: Accuracy of models to prognosticate survival after surgery for pancreatic cancer in the era of neoadjuvant therapy
Creators: Clayton T Marcinak - University of Wisconsin–Madison
William F Parker - University of Chicago
Alexander A Parikh - Mays Cancer Center at UT Health San Antonio
Jashodeep Datta - University of Miami
Shishir K Maithel - Emory University School of Medicine
David A Kooby - Emory University School of Medicine
Mark E Burkard - University of Wisconsin–Madison
Hong Jin Kim - University of North Carolina at Chapel Hill
Michael T LeCompte - University of North Carolina at Chapel Hill
Majid Afshar - University of Wisconsin–Madison
Matthew M Churpek - University of Wisconsin–Madison
Syed Nabeel Zafar - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Journal of surgical oncology, Vol.128(2), pp.280-288
DOI: 10.1002/jso.27287
PMID: 37073788
PMCID: PMC10330210
NLM abbreviation: J Surg Oncol
ISSN: 0022-4790
eISSN: 1096-9098
Grant note: R01 HL157262 / NHLBI NIH HHS K08 HL150291 / NHLBI NIH HHS T32 HG002760 / NHGRI NIH HHS P30 CA014520 / NCI NIH HHS R01 GM141068 / NIGMS NIH HHS NIH HHS R01 CA234904 / NCI NIH HHS
Language: English
Date published: 08/2023
Academic Unit: Internal Medicine
Record Identifier: 9984701255802771

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