Mortality risk for stage I NSCLC with poor histologic grade, tumor size ≥4 cm, and non-upper lobe tumor location: An epidemiologic study of 19,702 patients in the California Cancer Registry from 1989 to 2003

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7558-7558
Author(s):  
S. I. Ou ◽  
J. A. Zell ◽  
A. Ziogas ◽  
H. Anton-Culver
Keyword(s):  
Mortality Risk ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Tumor Location ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Stage Ib ◽  
California Cancer Registry ◽  
Stage Ia ◽  
Poorly Differentiated

7558 Background: Platinum-based adjuvant chemotherapy in randomized trials has failed to provide a survival benefit in stage I non-small-cell lung cancer (NSCLC). Using data from California Cancer Registry (CCR), we explored factors that have detrimental effect on survival in stage I NSCLC to identify a subset of patients at high risk for relapse and subsequent mortality. Methods: 19,702 stage I NSCLC cases in the CCR from 1989 to 2003 were identified and subgrouped into stage IA & IB disease. Patient demographic factors, tumor characteristics and treatment delivered were examined. Kaplan-Meier survival curves were calculated to estimate survival rates. Cox proportional hazards ratios were used to identify independent prognostic factors for survival. Results: Advanced age at diagnosis, male sex, low socioeconomic status (SES), non-surgical treatment & poorly-differentiated histologic grade (stage IA: hazard ratio [HR] = 1.14; 95% confidence interval [CI]: 1.08–1.19 & stage IB: HR = 1.11; 95% CI: 1.07–1.16) were factors identified with increased mortality risk on multivariate analysis. Non-upper lobe tumor location (RML/RLL/LLL) and tumor size ≥ 4 cm (vs < 4 cm; HR = 1.22; 95% CI: 1.15–1.30) were additional factors with increased mortality risk among stage IB patients. Conversely, bronchioloalveolar carcinoma (BAC)(vs adenocarcinoma: stage IA: HR = 0.81; 95% CI: 0.72–0.91 & stage IB: HR = 0.87, 95% CI: 0.77–0.98) & Asian ethnicity (vs Caucasian: stage IA: HR = 0.81, 95% CI: 0.70–0.94 & stage IB: HR = 0.80, 95% CI: 0.72–0.90) were associated with decreased mortality risk in stage I NSCLC. Lobectomy had the lowest HRs for death among all surgical techniques for both stage IA & IB NSCLC in the Cox proportional hazards model. Conclusions: Poorly-differentiated stage IA & IB NSCLC and stage IB NSCLC located in non-upper lobes or tumor size ≥ 4 cm carried an increased mortality risk on adjusted analysis. No significant financial relationships to disclose. [Table: see text]

The role of extensive lymphadenectomy in stage I ovarian cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5069-5069
Author(s):  
E. G. Munro ◽  
N. Karnik Lee ◽  
M. K. Cheung ◽  
K. Osann ◽  
A. Husain ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Proportional Hazards ◽  
Clear Cell ◽  
Median Number ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Extensive Lymphadenectomy ◽  
Stage Ib ◽  
Primary Surgery ◽  
Stage Ia

5069 Background: To determine if extent of lymphadenectomy affects the survival of women with stage I ovarian cancer. Methods: Demographic and clinico-pathologic information were obtained from the Surveillance, Epidemiology and End Results Program from 1988–2001 and analyzed using Kaplan-Meier methods and Cox proportional hazards regression. Results: Of the 6,686 women diagnosed with stage I ovarian cancer, 4,092 (61.2%) had stage IA, 392 (5.9%) had stage IB, 1,840 (27.5%) had stage IC, and 362 (5.4%) had unspecified stage I disease. The median age was 53 (range: 1–99). 5,625 (84.1%) were White, 388 (5.8%) Black, 488 (7.3%) Asian, and 185 (2.8%) were Other. All patients underwent primary surgery; of which, 3,824 women had no nodes, 1,533 had <10 nodes, and 1,329 had ≥10 nodes resected. Of the patients who underwent a lymphadenectomy, the median number of nodes resected was 9 (range: 1–84). The extent of lymphadenectomy (0, <10, and ≥10 nodes) increased the survival of patients with stage IC disease from 72.8%, 86.7%, to 90.1% (p < 0.0001), but not in those with stage IA (p = 0.07) or stage IB (p = 0.04) disease. In patients with non-clear cell epithelial carcinoma, the extent of lymphadenectomy was associated with improved 5-year disease-specific survivals of 85.6%, 93.3%, and 93.5%, respectively (p < 0.0001). However, the benefit associated with an extensive lymphadenectomy was not evident in clear cell (p = 0.09), sarcoma (p = 0.33), germ cell (p = 0.55), or sex cord stromal tumors of the ovary (p = 0.99). Similarly, patients with grade 3 disease had an improved survival associated with the extent of lymph node resection, 74.4%, 87.5%, to 90.5% (p < 0.0001), but not in those with grade 1 (p = 0.18) or grade 2 (p = 0.27) disease. In multivariate analysis, a more extensive lymphadenectomy remained significant as an independent prognostic factor for improved survival after adjusting for all other independent prognostic factors including age, surgery, histology, stage, and grade. Conclusions: Our findings suggest that the extent of lymphadenectomy was associated with an improvement in the survival of women with stage IC ovarian cancer. No significant financial relationships to disclose.

Prognostic value of clinicopathological factors in operated stage I non-small cell lung cancer (NSCLC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7222-7222
Author(s):  
R. Nakahara ◽  
H. Suzuki ◽  
H. Matsuguma ◽  
S. Igarashi ◽  
N. Miyazawa
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Stage I ◽  
Clinicopathological Factors ◽  
Stage Ib ◽  
Prognostic Group ◽  
Stage Ia ◽  
Resected Stage

7222 Background: Recently adjuvant chemotherapy has improved survival in resected stage I, especially stage IB NSCLC. While some cases with stage IA NSCLC have poor prognosis, there are no reliable clinicopathological markers to predict cancer related death. This study was conducted to identify the prognostic factors for resected stage IA and IB patients. Methods: We retrospectively analyzed 318 cases that were diagnosed with pathological stage I NSCLC from 1986 to 2000 at Tochigi Cancer Center. Various clinical and pathologic factors were reviewed, and the risk of a cancer related death was investigated. Analyzed factors were as follows: sex, age, smoking status, preoperative serum CEA level, tumor histological type, pathological differentiation, tumor size, lymphatic invasion (ly), vascular invasion (v), and pleural invasion (p). Results: The cancer specific 5-year survival rate for each stage were estimated to be 91% foe stage IA (n = 198) and 66% for stage IB (n = 120). In the stage IA subset, the univariate analysis revealed the following five factors to be poor prognostic factors: age 65 < (p = 0.008, Risk Ratio = 1.76), high CEA level (p < 0.001, RR = 2.09), tumor size 2 cm < (p = 0.008, RR = 1.75), ly (+) (p = 0.007, RR = 1.87), and v (+) (p = 0.003, RR = 1.77). The 5-year survival rate for stage IA patients that have three or more factors was 67% (n = 43). In the stage IB subset, the univariate analysis of clinicopathological factors revealed tumor size 4 cm < (p = 0.004, RR = 1.53), v (+) (p = 0.02, RR = 1.45), and no pleural invasion (p0) (p = 0.004, RR = 0.64) to be prognostic factors. The 5-year survival rate for stage IB patients that have all the good prognostic factors (tumor size 4 cm ≥, v(-), and p0) was 96% (n = 26). Conclusion: Our analysis suggests that the combination of prognostic factors revealed the poor prognostic group equal to stage IB patients in stage IA group. On the other hand, combination of prognostic factors revealed the good prognostic group in stage IB patients. It should be considered to do adjuvant chemotherapy with poor prognostic stage IA patients and avoid with good prognostic stage IB patients. No significant financial relationships to disclose.

scholarly journals Radiotherapy Plus Chemotherapy Is Associated With Improved Survival Compared to Radiotherapy Alone in Patients With Primary Vaginal Carcinoma: A Retrospective SEER Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Wei-li Zhou ◽  
Yang-yang Yue
Keyword(s):  
Tumor Size ◽  
Proportional Hazards ◽  
Risk Model ◽  
Figo Stage ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Vaginal Carcinoma ◽  
Radiotherapy Alone

BackgroundThe efficacy of radiotherapy plus chemotherapy (RTCT) versus radiotherapy alone (RT) in the treatment of primary vaginal carcinoma has been controversial. We aimed to evaluate the up-to-date efficacy of RTCT on primary vaginal carcinoma in a real-world cohort.MethodsWe performed a retrospective analysis in patients with primary vaginal carcinoma retrieved from the Surveillance, Epidemiology, and End Results Program database from 2004 to 2016. Kaplan–Meier survival curves were plotted and compared by the log-rank test. Inverse probability weighting (IPW)-adjusted multivariate Cox proportional hazards and Fine-Gray competing-risk model was applied.ResultsOf the 1,813 qualified patients with primary vaginal carcinoma from 2004 to 2016, 1,137 underwent RTCT and 676 underwent RT. The median survival time was 34 months for the RT group and 63 months for the RTCT group. RTCT was significantly associated with improved overall survival (unadjusted HR = 0.71, 95% CI 0.62–0.82, p &lt; 0.001; adjusted HR = 0.73, 95% CI 0.63–0.84, p &lt; 0.001) and cancer-specific survival (unadjusted sHR = 0.81, 95% CI 0.69–0.95, p = 0.012; adjusted sHR = 0.81, 95% CI 0.69–0.96, p = 0.016). Age, histological type, tumor size, surgery, and FIGO stage were all independent prognostic factors for survival (p &lt; 0.05 for all). Subgroup analysis demonstrated that RTCT was significantly associated with better survival in most subgroups, except for those with adenocarcinoma, tumor size &lt;2 cm, or FIGO stage I. Moreover, sensitivity analysis did not alter the beneficial effects of RTCT.ConclusionRTCT is significantly correlated with prolonged survival in patients with primary vaginal carcinoma. RTCT should be applied to most patients with primary vaginal carcinoma instead of RT alone, except for those with adenocarcinoma, tumor size &lt;2 cm, or FIGO stage I.

Population-based outcome of stages IA-IIA resected gastric adenocarcinoma: Who should get adjuvant treatment?

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 75-75
Author(s):  
Jason S. Gold ◽  
Riad H. Al Natour ◽  
Mandeep S. Saund ◽  
Charles H. Yoon ◽  
Ashish M. Sharma ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Adjuvant Treatment ◽  
Tumor Size ◽  
Locally Advanced ◽  
Tumor Location ◽  
Excellent Outcome ◽  
Stage Ib ◽  
Randomized Controlled Studies ◽  
Stage Ia ◽  
Well Differentiated

75 Background: The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized controlled studies that predominantly enrolled patients with locally advanced tumors. Thus its role for stage IIB – IIIC disease is widely accepted. Our aim was to identify patients with stage IA – IIA gastric adenocarcinoma who have a poor prognosis and therefore may benefit from adjuvant treatment. Methods: Patients with local or local-regional gastric adenocarcinoma who underwent surgical resection with pathological evaluation of ≥15 lymph nodes and had available disease-specific survival (DSS) data were identified from the Surveillance Epidemiology and End Results Registry. AJCC 7th edition gastric cancer staging was used. Kaplan-Meier survival was estimated. Survival differences were evaluated with the logrank test and Cox multivariate analysis. Results: TN grouping strongly predicted DSS (p<0.001, n=8515 patients). Stage IA (T1N0) (n=887) tumors had a distinctly excellent outcome, 91±1.2% DSS at 5 years, and thus were excluded from further analysis. The 5 TN groups of stages IB and IIA (n=1544) had the next best outcomes with DSS ranging from 66±4.6% to 81±2.3% at 5 years. Older age (p<0.001), higher grade (p=0.004), larger size (p<0.001), and proximal tumor location (p<0.001) were independent predictors of worse DSS in stage IB and IIA tumors. Interestingly, T and N stages did not independently predict outcome (p=0.07, p=0.41 respectively). We devised a risk stratification scheme for stage IB and IIA tumors where 1 point was assigned for each of the following variables: age >60 years, tumor size >5 cm, proximal tumor location, and grade other than well differentiated. DSS was 100% at 5 years for patients with no points (n=2); 86±4.3% for those with 1 point (n=92); 76±3.0%, 2 points (n=325); 72±2.8%, 3 points (n=372); and 48±4.9%, 4 points (n=136) (p<0.001). Conclusions: Patients with stage IB and IIA gastric adenocarcinomas with at least 2 adverse features (age >60 years, tumor size >5 cm, proximal tumor location, and grade other than well differentiated) have 5 year DSS ≤76%. Adjuvant therapy may be warranted for these patients.

Mortality disparities in insured patients with cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 150-150
Author(s):  
Robert Michael Cooper ◽  
Joanie Chung ◽  
Joanne E. Schottinger ◽  
Reina Haque
Keyword(s):  
Healthcare System ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Private Insurance ◽  
Cox Proportional Hazards ◽  
Healthcare Settings ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
California Cancer Registry ◽  
Insured Patients

150 Background: We examined mortality related to socioeconomic status (SES) in an insured Southern California population diagnosed with cancer and how healthcare settings can affect these differences. Methods: We identified adults diagnosed with the eight most common cancers from 2009-2014 from the California Cancer Registry and followed them through 2017. We calculated person-year mortality rates by SES and healthcare system (integrated healthcare system [IHS] or private insurance [PI]). Adjusted hazard ratios for the association between all-cause mortality and SES were estimated using Cox proportional hazards models accounting for covariates (race/ethnicity, demographics, stage, treatments). Results: The cohort was followed a maximum of 8 years. A total of 164,197 adults were diagnosed with cancers of the breast, prostate, lung, colon, melanoma, uterus, kidney and bladder (N=47,039 in IHS and N=117,158 in PI). In the whole cohort, we found an increased mortality risk between the highest and each of the lower SES quintiles. Specifically, the adjusted mortality risk was 16 to 37% greater in the lower SES groups as compared to the highest. We then examined the mortality in the IHS and PI groups separately. Overall mortality for all cancers combined was slightly lower in the IHS group (74.7/1,000 PY) than in the PI group (87.8/1,000 PY). In multivariable models, mortality risk was 6% to 16% greater in the lower SES groups versus the highest SES in the IHS population, while the risk was 19% to 45% greater in the lower SES groups in the PI population. Conclusions: Even among insured patients, and after multivariable adjustment, we found disparities in mortality in the lower SES groups. However, the magnitude of these differences was lower in patients cared for in IHS than those with PI. Preliminary data suggest that IHS may be well positioned to reduce disparity gaps in cancer outcomes. [Table: see text]

scholarly journals High School Quality and 56-Year All-Cause Mortality Risk Across Race and Ethnicity

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 505-506
Author(s):  
Dominika Seblova ◽  
Kelly Peters ◽  
Susan Lapham ◽  
Laura Zahodne ◽  
Tara Gruenewald ◽  
...  
Keyword(s):  
High School ◽  
Mortality Risk ◽  
Race And Ethnicity ◽  
Proportional Hazards ◽  
School Quality ◽  
Cox Proportional Hazards ◽  
School Level ◽  
Lower Mortality ◽  
All Cause Mortality ◽  
Race Ethnicity

Abstract Having more years of education is independently associated with lower mortality, but it is unclear whether other attributes of schooling matter. We examined the association of high school quality and all-cause mortality across race/ethnicity. In 1960, about 5% of US high schools participated in Project Talent (PT), which collected information about students and their schools. Over 21,000 PT respondents were followed for mortality into their eighth decade of life using the National Death Index. A school quality factor, capturing term length, class size, and teacher qualifications, was used as the main predictor. First, we estimated overall and sex-stratified Cox proportional hazards models with standard errors clustered at the school level, adjusting for age, sex, composite measure of parental socioeconomic status, and 1960 cognitive ability. Second, we added an interaction between school quality and race/ethnicity. Among this diverse cohort (60% non-Hispanic Whites, 23% non-Hispanic Blacks, 7% Hispanics, 10% classified as another race/s) there were 3,476 deaths (16.5%). School quality was highest for Hispanic respondents and lowest for non-Hispanic Blacks. Non-Hispanic Blacks also had the highest mortality risk. In the whole sample, school quality was not associated with mortality risk. However, higher school quality was associated with lower mortality among those classified as another race/s (HR 0.75, 95% CI: 0.56-0.99). For non-Hispanic Blacks and Whites, the HR point estimates were unreliable, but suggest that higher school quality is associated with increased mortality. Future work will disentangle these differences in association of school quality across race/ethnicity and examine cause-specific mortality.

scholarly journals Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

2021 ◽  
Author(s):  
Claudius E. Degro ◽  
Richard Strozynski ◽  
Florian N. Loch ◽  
Christian Schineis ◽  
Fiona Speichinger ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Blood Level ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Cancer Stage ◽  
Single Center ◽  
Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

A Motion of No Confidence: Leadership and Rebel Fragmentation

2020 ◽  
Vol 5 (4) ◽  
pp. 598-616 ◽  
Author(s):  
Austin C Doctor
Keyword(s):  
Civil War ◽  
Proportional Hazards ◽  
Original Data ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Logistic Regression Models ◽  
Structure And Agency ◽  
Rebel Groups ◽  
Cox Proportional Hazards Models ◽  
War Experiences

Abstract Why do rebel organizations splinter into competing factions during civil war? To explain this outcome, I leverage variation in rebel leadership. I argue that rebel leaders draw on their pre-war experiences—i.e., their military and political experiences—to manage their organizations during conflict. These experiences bear unique patterns of rebel management and, thus, corresponding risks of fragmentation. Empirical evidence comes from a two-stage research design and original data featuring over 200 rebel leaders from 1989 to 2014. In the first stage, I estimate the probability of group fragmentation with a series of logistic regression models. In the second stage, I use Cox proportional-hazards models to estimate leadership effects on the rate of group fragmentation. Results indicate that variation in rebel leadership corresponds with unique risks of fragmentation. In particular, the results suggest that leaders with real military experience are best equipped to maintain group cohesion. This study offers insight into the processes by which rebel groups splinter into armed factions. In addition, it makes an important contribution to the broader discussion on the roles of structure and agency in shaping the dynamics of civil war.

scholarly journals The Joint Effects of Loneliness and Depression on Mortality: Does Gender Matter?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 323-323
Author(s):  
Ted Kheng Siang Ng ◽  
Abhijit Visaria ◽  
Angelique W M Chan ◽  
Kheng Siang Ted Ng
Keyword(s):  
Los Angeles ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Depression Scale ◽  
Well Being ◽  
Joint Effect ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Increased Risk

Abstract Loneliness and depression are both associated with an increased risk of all-cause mortality among older adults. However, the evidence on the joint effect of loneliness and depression is scarce. Furthermore, previous research has rarely examined the modifying effects of gender. We investigated these questions using the Panel on Health and Aging of Singaporean Elderly, a nationally-representative cohort study of community-dwelling older Singaporean adults aged 60 and above, conducted in 2009 with two follow-up waves in 2011 and 2015 (N=4536). We operationalized six groups based on three categories of loneliness measured using the 3-item University of California, Los Angeles (UCLA) loneliness scale: always lonely, sometimes lonely, and never lonely; Two categories of depressive symptom scores were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D) scale: depressed and not depressed. Cox proportional hazards models were employed to estimate the mortality risks for each group, with an extensive set of covariates. Due to significant differences in the prevalence of loneliness and depression in different genders, we conducted gender-stratified analyses. Compared to being not depressed and never lonely, women who were depressed and sometimes lonely and who were not depressed but always lonely had a higher mortality risk. Men who were not depressed but sometimes lonely had a higher mortality risk. We conclude that loneliness appears to be the predominant construct in conferring excess mortality risk. Health policies and interventions addressing the factors common and unique to each gender may improve psychological well-being at older ages, thereby extending the lifespan.

scholarly journals Individualized Prediction of Survival Benefits of Pancreatectomy Plus Chemotherapy in Patients With Simultaneous Metastatic Pancreatic Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Duorui Nie ◽  
Guihua Lai ◽  
Guilin An ◽  
Zhuojun Wu ◽  
Shujun Lei ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Survival Curve ◽  
Characteristic Curve ◽  
Cox Proportional Hazards ◽  
Metastatic Pancreatic Cancer ◽  
Calibration Plot ◽  
Term Survival ◽  
Good Ability

BackgroundMetastatic pancreatic cancer (mPC) is a highly lethal malignancy with poorer survival. However, chemotherapy alone was unable to maintain long‐term survival. This study aimed to evaluate the individualized survival benefits of pancreatectomy plus chemotherapy (PCT) for mPC.MethodsA total of 4546 patients with mPC from 2004 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. The survival curve was calculated using the Kaplan-Meier method and differences in survival curves were tested using log-rank tests. Cox proportional hazards regression analyses were performed to evaluate the prognostic value of involved variables. A new nomogram was constructed to predict overall survival based on independent prognosis factors. The performance of the nomogram was measured by concordance index, calibration plot, and area under the receiver operating characteristic curve.ResultsCompared to pancreatectomy or chemotherapy alone, PCT can significantly improve the prognosis of patients with mPC. In addition, patients with well/moderately differentiated tumors, age ≤66 years, tumor size ≤42 mm, or female patients were more likely to benefit from PCT. Multivariate analysis showed that age at diagnosis, sex, marital status, grade, tumor size, and treatment were independent prognostic factors. The established nomogram has a good ability to distinguish and calibrating.ConclusionPCT can prolong survival in some patients with mPC. Our nomogram can individualize predict OS of pancreatectomy combined with chemotherapy in patients with concurrent mPC.

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