Development and validation of an individualized nomogram for predicting pancreatic adenocarcinoma-specific survival: A SEER population analysis of 5,805 patients

OBJECTIVE: A model to predict the overall survival (OS) of pancreatic adenocarcinoma (PAC) is required in consideration of its inferior prognosis. PATIENTS AND METHODS: The patients diagnosed with pancreatic cancer between 1975 and 2016 in the Surveillance, Epidemiology, and End Results (SEER) database was used as raw data. A training cohort and a verification cohort were used for internal validation and external validation, respectively. The nomogram model was constructed to predict the OS. RESULTS: A total of 5,805 patients with PAC from 2010-2015 were analyzed. Most patients were over 65 years old (61.8%), white (81.2%), in stage IIA, IIB (49.0%), and IV (32.4%), less than 50 mm in diameter (80.2%). PAC patients with wide involvement range, no metastasis, and infiltration range more than 300 accounted for 58.2%, 67.6%, 78.2%, respectively. The vast majority of the PAC patients (90.9%) did not receive primary site surgery. Most of the PAC patients (68.1%) received chemotherapy and only 25.8% of PAC patients received radiotherapy. The overall mean survival time, overall median survival time and overall survival rate were 15.1 months, 10.0 months, and 16.7%, respectively. CONCLUSIONS: Our nomogram that based on age, chemotherapy, grade, Radiation sequence with surgery, Radiation recode, RX Summ-Surg Prim at Site (surgery that removes and/or destroys primary tumor performed as part of the first course of therapy), size, and stage was of well prediction ability.