Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas

Background The accurate prognosis for patients with resectable pancreatic adenocarcinomas requires the incorporation of more factors than those included in AJCC TNM system. Methods We identified 218 patients diagnosed with stage I and II pancreatic adenocarcinoma at NewYork-Presbyterian Hospital/Col...

Full description

Bibliographic Details
Main Authors: Taxiarchis Botsis, Valsamo K. Anagnostou, Gunnar Hartvigsen, George Hripcsak, Chunhua Weng
Format: Article
Language:English
Published: SAGE Publishing 2009-01-01
Series:Cancer Informatics
Online Access:https://doi.org/10.4137/CIN.S3835
_version_ 1818035417473089536
author Taxiarchis Botsis
Valsamo K. Anagnostou
Gunnar Hartvigsen
George Hripcsak
Chunhua Weng
author_facet Taxiarchis Botsis
Valsamo K. Anagnostou
Gunnar Hartvigsen
George Hripcsak
Chunhua Weng
author_sort Taxiarchis Botsis
collection DOAJ
description Background The accurate prognosis for patients with resectable pancreatic adenocarcinomas requires the incorporation of more factors than those included in AJCC TNM system. Methods We identified 218 patients diagnosed with stage I and II pancreatic adenocarcinoma at NewYork-Presbyterian Hospital/Columbia University Medical Center (1999 to 2009). Tumor and clinical characteristics were retrieved and associations with survival were assessed by univariate Cox analysis. A multivariable model was constructed and a prognostic score was calculated; the prognostic strength of our model was assessed with the concordance index. Results Our cohort had a median age of 67 years and consisted of 49% men; the median follow-up time was 14.3 months and the 5-year survival 3.6%. Age, tumor differentiation and size, alkaline phosphatase, albumin and CA 19–9 were the independent factors of the final multivariable model; patients were thus classified into low (n = 14, median survival = 53.7 months), intermediate (n = 124, median survival = 19.7 months) and high risk groups (n = 80, median survival = 12.3 months). The prognostic classification of our model remained significant after adjusting for adjuvant chemotherapy and the concordance index was 0.73 compared to 0.59 of the TNM system. Conclusion Our prognostic model was accurate in stratifying patients by risk and could be incorporated into clinical decisions.
first_indexed 2024-12-10T06:54:43Z
format Article
id doaj.art-0d025734efa24a06889b92bea9ca9fb8
institution Directory Open Access Journal
issn 1176-9351
language English
last_indexed 2024-12-10T06:54:43Z
publishDate 2009-01-01
publisher SAGE Publishing
record_format Article
series Cancer Informatics
spelling doaj.art-0d025734efa24a06889b92bea9ca9fb82022-12-22T01:58:28ZengSAGE PublishingCancer Informatics1176-93512009-01-01710.4137/CIN.S3835Modeling Prognostic Factors in Resectable Pancreatic AdenocarcinomasTaxiarchis Botsis0Valsamo K. Anagnostou1Gunnar Hartvigsen2George Hripcsak3Chunhua Weng4Department of Computer Science, University of Tromsø, 9037 Tromsø, Norway.Department of Pathology, Yale University School of Medicine, 06511 New Haven, USA.Department of Computer Science, University of Tromsø, 9037 Tromsø, Norway.Department of Biomedical Informatics, Columbia University, 10032 New York, USA.Department of Biomedical Informatics, Columbia University, 10032 New York, USA.Background The accurate prognosis for patients with resectable pancreatic adenocarcinomas requires the incorporation of more factors than those included in AJCC TNM system. Methods We identified 218 patients diagnosed with stage I and II pancreatic adenocarcinoma at NewYork-Presbyterian Hospital/Columbia University Medical Center (1999 to 2009). Tumor and clinical characteristics were retrieved and associations with survival were assessed by univariate Cox analysis. A multivariable model was constructed and a prognostic score was calculated; the prognostic strength of our model was assessed with the concordance index. Results Our cohort had a median age of 67 years and consisted of 49% men; the median follow-up time was 14.3 months and the 5-year survival 3.6%. Age, tumor differentiation and size, alkaline phosphatase, albumin and CA 19–9 were the independent factors of the final multivariable model; patients were thus classified into low (n = 14, median survival = 53.7 months), intermediate (n = 124, median survival = 19.7 months) and high risk groups (n = 80, median survival = 12.3 months). The prognostic classification of our model remained significant after adjusting for adjuvant chemotherapy and the concordance index was 0.73 compared to 0.59 of the TNM system. Conclusion Our prognostic model was accurate in stratifying patients by risk and could be incorporated into clinical decisions.https://doi.org/10.4137/CIN.S3835
spellingShingle Taxiarchis Botsis
Valsamo K. Anagnostou
Gunnar Hartvigsen
George Hripcsak
Chunhua Weng
Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
Cancer Informatics
title Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
title_full Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
title_fullStr Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
title_full_unstemmed Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
title_short Modeling Prognostic Factors in Resectable Pancreatic Adenocarcinomas
title_sort modeling prognostic factors in resectable pancreatic adenocarcinomas
url https://doi.org/10.4137/CIN.S3835
work_keys_str_mv AT taxiarchisbotsis modelingprognosticfactorsinresectablepancreaticadenocarcinomas
AT valsamokanagnostou modelingprognosticfactorsinresectablepancreaticadenocarcinomas
AT gunnarhartvigsen modelingprognosticfactorsinresectablepancreaticadenocarcinomas
AT georgehripcsak modelingprognosticfactorsinresectablepancreaticadenocarcinomas
AT chunhuaweng modelingprognosticfactorsinresectablepancreaticadenocarcinomas