Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival

Cristina R. Ferrone, Michael W. Kattan, James S. Tomlinson, Sarah P. Thayer, Murray F. Brennan, Andrew L. Warshaw

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Purpose: Nomograms are statistically based tools that provide the overall probability of a specific outcome. They have shown better individual discrimination than the current TNM staging system in numerous patient tumor models. The pancreatic nomogram combines individual clinicopathologic and operative data to predict disease-specific survival at 1, 2, and 3 years from initial resection. A single US institution database was used to test the validity of the pancreatic adenocarcinoma nomogram established at Memorial Sloan-Kettering Cancer Center. Patients and Methods: The nomogram was created from a prospective pancreatic adenocarcinoma database that included 555 consecutive patients between October 1983 and April 2000. The nomogram was validated by an external patient cohort from a retrospective pancreatic adenocarcinoma database at Massachusetts General Hospital that included 424 consecutive patients between January 1985 and December 2003. Results: Of the 424 patients, 375 had all variables documented. At last follow-up, 99 patients were alive, with a median follow-up time of 27 months (range, 2 to 151 months). The 1-, 2-, and 3-year disease-specific survival rates were 68% (95% CI, 63% to 72%), 39% (95% CI, 34% to 44%), and 27% (95% CI, 23% to 32%), respectively. The nomogram concordance index was 0.62 compared with 0.59 with the American Joint Committee on Cancer (AJCC) stage (P = .004). This suggests that the nomogram discriminates disease-specific survival better than the AJCC staging system. Conclusion: The pancreatic cancer nomogram provides more accurate survival predictions than the AJCC staging system when applied to an external patient cohort. The nomogram may aid in more accurately counseling patients and in better stratifying patients for clinical trials and molecular tumor analysis.

Original languageEnglish (US)
Pages (from-to)7529-7535
Number of pages7
JournalJournal of Clinical Oncology
Volume23
Issue number30
DOIs
StatePublished - Dec 1 2005

Fingerprint

Nomograms
Adenocarcinoma
Survival
Neoplasm Staging
Databases
Neoplasms
Pancreatic Neoplasms
General Hospitals
Counseling
Survival Rate
Clinical Trials

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival. / Ferrone, Cristina R.; Kattan, Michael W.; Tomlinson, James S.; Thayer, Sarah P.; Brennan, Murray F.; Warshaw, Andrew L.

In: Journal of Clinical Oncology, Vol. 23, No. 30, 01.12.2005, p. 7529-7535.

Research output: Contribution to journalArticle

Ferrone, Cristina R. ; Kattan, Michael W. ; Tomlinson, James S. ; Thayer, Sarah P. ; Brennan, Murray F. ; Warshaw, Andrew L. / Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 30. pp. 7529-7535.
@article{53635f7775c14c68a4916f7a5aa72d69,
title = "Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival",
abstract = "Purpose: Nomograms are statistically based tools that provide the overall probability of a specific outcome. They have shown better individual discrimination than the current TNM staging system in numerous patient tumor models. The pancreatic nomogram combines individual clinicopathologic and operative data to predict disease-specific survival at 1, 2, and 3 years from initial resection. A single US institution database was used to test the validity of the pancreatic adenocarcinoma nomogram established at Memorial Sloan-Kettering Cancer Center. Patients and Methods: The nomogram was created from a prospective pancreatic adenocarcinoma database that included 555 consecutive patients between October 1983 and April 2000. The nomogram was validated by an external patient cohort from a retrospective pancreatic adenocarcinoma database at Massachusetts General Hospital that included 424 consecutive patients between January 1985 and December 2003. Results: Of the 424 patients, 375 had all variables documented. At last follow-up, 99 patients were alive, with a median follow-up time of 27 months (range, 2 to 151 months). The 1-, 2-, and 3-year disease-specific survival rates were 68{\%} (95{\%} CI, 63{\%} to 72{\%}), 39{\%} (95{\%} CI, 34{\%} to 44{\%}), and 27{\%} (95{\%} CI, 23{\%} to 32{\%}), respectively. The nomogram concordance index was 0.62 compared with 0.59 with the American Joint Committee on Cancer (AJCC) stage (P = .004). This suggests that the nomogram discriminates disease-specific survival better than the AJCC staging system. Conclusion: The pancreatic cancer nomogram provides more accurate survival predictions than the AJCC staging system when applied to an external patient cohort. The nomogram may aid in more accurately counseling patients and in better stratifying patients for clinical trials and molecular tumor analysis.",
author = "Ferrone, {Cristina R.} and Kattan, {Michael W.} and Tomlinson, {James S.} and Thayer, {Sarah P.} and Brennan, {Murray F.} and Warshaw, {Andrew L.}",
year = "2005",
month = "12",
day = "1",
doi = "10.1200/JCO.2005.01.8101",
language = "English (US)",
volume = "23",
pages = "7529--7535",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "30",

}

TY - JOUR

T1 - Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival

AU - Ferrone, Cristina R.

AU - Kattan, Michael W.

AU - Tomlinson, James S.

AU - Thayer, Sarah P.

AU - Brennan, Murray F.

AU - Warshaw, Andrew L.

PY - 2005/12/1

Y1 - 2005/12/1

N2 - Purpose: Nomograms are statistically based tools that provide the overall probability of a specific outcome. They have shown better individual discrimination than the current TNM staging system in numerous patient tumor models. The pancreatic nomogram combines individual clinicopathologic and operative data to predict disease-specific survival at 1, 2, and 3 years from initial resection. A single US institution database was used to test the validity of the pancreatic adenocarcinoma nomogram established at Memorial Sloan-Kettering Cancer Center. Patients and Methods: The nomogram was created from a prospective pancreatic adenocarcinoma database that included 555 consecutive patients between October 1983 and April 2000. The nomogram was validated by an external patient cohort from a retrospective pancreatic adenocarcinoma database at Massachusetts General Hospital that included 424 consecutive patients between January 1985 and December 2003. Results: Of the 424 patients, 375 had all variables documented. At last follow-up, 99 patients were alive, with a median follow-up time of 27 months (range, 2 to 151 months). The 1-, 2-, and 3-year disease-specific survival rates were 68% (95% CI, 63% to 72%), 39% (95% CI, 34% to 44%), and 27% (95% CI, 23% to 32%), respectively. The nomogram concordance index was 0.62 compared with 0.59 with the American Joint Committee on Cancer (AJCC) stage (P = .004). This suggests that the nomogram discriminates disease-specific survival better than the AJCC staging system. Conclusion: The pancreatic cancer nomogram provides more accurate survival predictions than the AJCC staging system when applied to an external patient cohort. The nomogram may aid in more accurately counseling patients and in better stratifying patients for clinical trials and molecular tumor analysis.

AB - Purpose: Nomograms are statistically based tools that provide the overall probability of a specific outcome. They have shown better individual discrimination than the current TNM staging system in numerous patient tumor models. The pancreatic nomogram combines individual clinicopathologic and operative data to predict disease-specific survival at 1, 2, and 3 years from initial resection. A single US institution database was used to test the validity of the pancreatic adenocarcinoma nomogram established at Memorial Sloan-Kettering Cancer Center. Patients and Methods: The nomogram was created from a prospective pancreatic adenocarcinoma database that included 555 consecutive patients between October 1983 and April 2000. The nomogram was validated by an external patient cohort from a retrospective pancreatic adenocarcinoma database at Massachusetts General Hospital that included 424 consecutive patients between January 1985 and December 2003. Results: Of the 424 patients, 375 had all variables documented. At last follow-up, 99 patients were alive, with a median follow-up time of 27 months (range, 2 to 151 months). The 1-, 2-, and 3-year disease-specific survival rates were 68% (95% CI, 63% to 72%), 39% (95% CI, 34% to 44%), and 27% (95% CI, 23% to 32%), respectively. The nomogram concordance index was 0.62 compared with 0.59 with the American Joint Committee on Cancer (AJCC) stage (P = .004). This suggests that the nomogram discriminates disease-specific survival better than the AJCC staging system. Conclusion: The pancreatic cancer nomogram provides more accurate survival predictions than the AJCC staging system when applied to an external patient cohort. The nomogram may aid in more accurately counseling patients and in better stratifying patients for clinical trials and molecular tumor analysis.

UR - http://www.scopus.com/inward/record.url?scp=32944478926&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=32944478926&partnerID=8YFLogxK

U2 - 10.1200/JCO.2005.01.8101

DO - 10.1200/JCO.2005.01.8101

M3 - Article

C2 - 16234519

AN - SCOPUS:32944478926

VL - 23

SP - 7529

EP - 7535

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 30

ER -