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Development and validation of a nomogram for predicting the probability of death within 3 months in patients with advanced pancreatic ductal adenocarcinoma

Shu Dong  Chenchen Wang  Chenyue Zhang  Lei Wang  Haifeng Ying  Xiaoheng Shen  Yuanbiao Guo  Yehua Shen  Hao Chen  Qinglong Deng  Yaxuan Zhang  Jinming Yu  Zhiqiang Meng  Zhaoshen Li  Qiwen Chen  
【摘要】:Background: The prognosis of advanced pancreatic ductal adenocarcinoma(PDAC) is diverse among different patients. Therefore a vehicle to assess its prognosis is of great clinical significance. The study aimed to construct and validate a nomogram to predict the probability of death within 3 months in patients with advanced PDAC. Methods: The nomogram was based on a prospective multicenter cohort study involving 1,526 advanced PDAC patients from three participating hospitals in China. Two thirds of the patients were randomly assigned to the training set(n=1,017), and one third were assigned to the validation set(n=509). Multivariate logistic regression analysis was performed to identify factors associated with death within 3 months to develop the nomogram. Internal and external validation using C-index and calibration curve were conducted in the training set and validation set respectively. Results: Eight independent factors(gender, age, smoking, tumor stage, ALT, ALB, CA19-9, HBV infection status) as identified by multivariate logistic model were entered into the nomogram. The calibration curves for predicting probability of death within 3 months showed satisfactory accordance between nomogram prediction and actual observation. The C-indexes of the proposed nomogram were 0.822 in the training set and 0.841 in the validation set. Conclusions: The proposed nomogram can serve as an effective tool for predicting the probability of death within 3 months in patients with advanced PDAC.

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