Prognostic estimator of survival for patients with localized and extended pancreatic ductal adenocarcinoma.
Prognostic estimator of survival for patients with localized and extended pancreatic ductal adenocarcinoma.
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DOI：
10.4137/cin.s11496
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发表时间：
2013
影响因子：
2
通讯作者：
Sherman S
中科院分区：
文献类型：
--
作者：
Gleason MX;Mdzinarishvili T;Are C;Sasson A;Sherman A;Shats O;Sherman S
使用Kaplan-Meier方法对来自监测流行病学和最终结果(SEER)数据库的18,352例胰腺导管腺癌(PDAC)病例进行了以下变量的分析：种族、性别、婚姻状况、确诊年份、确诊年龄、胰腺亚部位、T分期、N分期、M分期、肿瘤大小、肿瘤分级、手术和放射治疗。由于T分期变量不满足比例风险假设，将病例分为T1和T2期(局限性肿瘤)和T3和T4期(扩大肿瘤)。为了估计每一组的生存概率和条件生存概率，建立了调整剩余协变量的多变量Cox回归模型。对模型参数的重现性和泛化能力的检验表明，模型具有较好的定标能力，其一致性指数分别为0.702和0.712。在这些模型的基础上，开发了诊断为PDAC患者的生存预后估计器，并将其作为基于网络的计算机化工具来实现。
The 18,352 pancreatic ductal adenocarcinoma (PDAC) cases from the Surveillance Epidemiology and End Results (SEER) database were analyzed using the Kaplan-Meier method for the following variables: race, gender, marital status, year of diagnosis, age at diagnosis, pancreatic subsite, T-stage, N-stage, M-stage, tumor size, tumor grade, performed surgery, and radiation therapy. Because the T-stage variable did not satisfy the proportional hazards assumption, the cases were divided into cases with T1- and T2-stages (localized tumor) and cases with T3- and T4-stages (extended tumor). For estimating survival and conditional survival probabilities in each group, a multivariate Cox regression model adjusted for the remaining covariates was developed. Testing the reproducibility of model parameters and generalizability of these models showed that the models are well calibrated and have concordance indexes equal to 0.702 and 0.712, respectively. Based on these models, a prognostic estimator of survival for patients diagnosed with PDAC was developed and implemented as a computerized web-based tool.