Prognostic nomogram and score to predict overall survival in locally advanced untreated pancreatic cancer (PROLAP)
Identifieur interne : 001891 ( Main/Exploration ); précédent : 001890; suivant : 001892Prognostic nomogram and score to predict overall survival in locally advanced untreated pancreatic cancer (PROLAP)
Auteurs : Dewi Vernerey [France] ; Florence Huguet [France] ; Angélique Vienot [France] ; David Goldstein [Australie] ; Sophie Paget-Bailly [France] ; Jean-Luc Van Laethem [Belgique] ; Bengt Glimelius [Suède] ; Pascal Artru [France] ; Malcolm J. Moore [Canada] ; Thierry André [France] ; Laurent Mineur [France] ; Benoist Chibaudel [France] ; Magdalena Benetkiewicz [France] ; Christophe Louvet [France] ; Pascal Hammel [France] ; Franck Bonnetain [France]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Tumeurs du pancréas.
- mortalité : Tumeurs du pancréas.
- Adulte d'âge moyen, Analyse de survie, Femelle, Humains, Modèles de hasards proportionnels, Mâle, Pronostic, Sujet âgé, Études de cohortes.
English descriptors
- KwdEn :
- MESH :
- mortality : Pancreatic Neoplasms.
- pathology : Pancreatic Neoplasms.
- Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Prognosis, Proportional Hazards Models, Survival Analysis.
Abstract
The management of locally advanced pancreatic cancer (LAPC) patients remains controversial. Better discrimination for overall survival (OS) at diagnosis is needed. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP).
Analyses were derived from 442 LAPC patients enrolled in the LAP07 trial. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. Performance assessment and internal validation of the final model were done with Harrell's C-index, calibration plot and bootstrap sample procedures. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besançon Hospital, France.
Age, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. The final model had good calibration, acceptable discrimination (C-index=0.60) and robust internal validity. The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank
The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future.
Url:
DOI: 10.1038/bjc.2016.212
PubMed: 27404456
PubMed Central: 4973163
Affiliations:
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Huguet</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Radiotherapy, Tenon Hospital (AP-HP)</institution>, 4 rue de la Chine, Paris 75020,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Vienot, Angelique" sort="Vienot, Angelique" uniqKey="Vienot A" first="Angélique" last="Vienot">Angélique Vienot</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Gastroenterology, University Hospital of Besançon</institution>, 3 Boulevard Alexandre Fleming, Besançon 25030,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Goldstein, David" sort="Goldstein, David" uniqKey="Goldstein D" first="David" last="Goldstein">David Goldstein</name><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Medical Oncology, Prince of Wales hospital and Prince of Wales Clinical school, UNSW</institution>, Sydney, New South Wales 2031,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>AGITG (Australasian Gastrointestinal Trials Group)</institution>, 119-143 Missenden Rd, Camperdown, New South Wales 2050,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Paget Bailly, Sophie" sort="Paget Bailly, Sophie" uniqKey="Paget Bailly S" first="Sophie" last="Paget-Bailly">Sophie Paget-Bailly</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon</institution>, 3 Boulevard Alexandre Fleming, Besançon 25030,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Laethem, Jean Luc" sort="Van Laethem, Jean Luc" uniqKey="Van Laethem J" first="Jean-Luc" last="Van Laethem">Jean-Luc Van Laethem</name><affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Department of Gastroenterology, Erasme University Hospital</institution>, Route de Lennik 808, Brussels 1070,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Glimelius, Bengt" sort="Glimelius, Bengt" uniqKey="Glimelius B" first="Bengt" last="Glimelius">Bengt Glimelius</name><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Department of Radiology, Oncology and Radiation Science, University of Uppsala</institution>, Uppsala 75105,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Artru, Pascal" sort="Artru, Pascal" uniqKey="Artru P" first="Pascal" last="Artru">Pascal Artru</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff9"><institution>Department of Gastroenterology, Jean Mermoz Hospital</institution>, 55 avenue Mermoz, Lyon 69008,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Moore, Malcolm J" sort="Moore, Malcolm J" uniqKey="Moore M" first="Malcolm J" last="Moore">Malcolm J. Moore</name><affiliation wicri:level="1"><nlm:aff id="aff10"><institution>Department of Medical Oncology, Princess Margaret Hospital</institution>, 610 University Avenue, Toronto, Ontario M5G 2M9,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Andre, Thierry" sort="Andre, Thierry" uniqKey="Andre T" first="Thierry" last="André">Thierry André</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Department of Medical Oncology, Saint-Antoine Hospital (AP-HP)</institution>, 184 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mineur, Laurent" sort="Mineur, Laurent" uniqKey="Mineur L" first="Laurent" last="Mineur">Laurent Mineur</name><affiliation wicri:level="1"><nlm:aff id="aff12"><institution>Department of Radiotherapy and Medical Oncology, Sainte-Catherine Institute</institution>, 250 Chemin de Baigne Pieds, Avignon 84918,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chibaudel, Benoist" sort="Chibaudel, Benoist" uniqKey="Chibaudel B" first="Benoist" last="Chibaudel">Benoist Chibaudel</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff13"><institution>Department of Medical Oncology, Franco-British Hospital Institute</institution>, 3 Rue Barbès, Levallois-Perret 92300,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Benetkiewicz, Magdalena" sort="Benetkiewicz, Magdalena" uniqKey="Benetkiewicz M" first="Magdalena" last="Benetkiewicz">Magdalena Benetkiewicz</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Louvet, Christophe" sort="Louvet, Christophe" uniqKey="Louvet C" first="Christophe" last="Louvet">Christophe Louvet</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff14"><institution>Department of Medical Oncology, Institute Mutualiste Montsouris</institution>, 42 Boulevard Jourdan, Paris 75014,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hammel, Pascal" sort="Hammel, Pascal" uniqKey="Hammel P" first="Pascal" last="Hammel">Pascal Hammel</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff15"><institution>Department of Digestive Oncology, Beaujon Hospital (AP-HP)</institution>, 100 boulevard du General Leclerc, Clichy 92110,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bonnetain, Franck" sort="Bonnetain, Franck" uniqKey="Bonnetain F" first="Franck" last="Bonnetain">Franck Bonnetain</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon</institution>, 3 Boulevard Alexandre Fleming, Besançon 25030,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Oncology Multidisciplinary Research Group (GERCOR)</institution>, 151 rue du Faubourg Saint Antoine, Paris 75011,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Cancer</title><idno type="ISSN">0007-0920</idno><idno type="eISSN">1532-1827</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pancreatic Neoplasms (mortality)</term><term>Pancreatic Neoplasms (pathology)</term><term>Prognosis</term><term>Proportional Hazards Models</term><term>Survival Analysis</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Femelle</term><term>Humains</term><term>Modèles de hasards proportionnels</term><term>Mâle</term><term>Pronostic</term><term>Sujet âgé</term><term>Tumeurs du pancréas (anatomopathologie)</term><term>Tumeurs du pancréas (mortalité)</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du pancréas</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Pancreatic Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Tumeurs du pancréas</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Pancreatic Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Proportional Hazards Models</term><term>Survival Analysis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Femelle</term><term>Humains</term><term>Modèles de hasards proportionnels</term><term>Mâle</term><term>Pronostic</term><term>Sujet âgé</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>The management of locally advanced pancreatic cancer (LAPC) patients remains controversial. Better discrimination for overall survival (OS) at diagnosis is needed. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP).</p></sec><sec><title>Methods:</title><p>Analyses were derived from 442 LAPC patients enrolled in the LAP07 trial. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. Performance assessment and internal validation of the final model were done with Harrell's C-index, calibration plot and bootstrap sample procedures. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besançon Hospital, France.</p></sec><sec><title>Results:</title><p>Age, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. The final model had good calibration, acceptable discrimination (C-index=0.60) and robust internal validity. The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank <italic>P</italic><0.0001). The score ability to discriminate OS was externally confirmed in 63 (59%) patients with complete clinical data derived from a data set of 106 consecutive LAPC patients; median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank <italic>P</italic><0.0001).</p></sec><sec><title>Conclusions:</title><p>The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>Belgique</li><li>Canada</li><li>France</li><li>Suède</li></country></list><tree><country name="France"><noRegion><name sortKey="Vernerey, Dewi" sort="Vernerey, Dewi" uniqKey="Vernerey D" first="Dewi" last="Vernerey">Dewi Vernerey</name></noRegion><name sortKey="Andre, Thierry" sort="Andre, Thierry" uniqKey="Andre T" first="Thierry" last="André">Thierry André</name><name sortKey="Andre, Thierry" sort="Andre, Thierry" uniqKey="Andre T" first="Thierry" last="André">Thierry André</name><name sortKey="Artru, Pascal" sort="Artru, Pascal" uniqKey="Artru P" first="Pascal" last="Artru">Pascal Artru</name><name sortKey="Artru, Pascal" sort="Artru, Pascal" uniqKey="Artru P" first="Pascal" last="Artru">Pascal Artru</name><name sortKey="Benetkiewicz, Magdalena" sort="Benetkiewicz, Magdalena" uniqKey="Benetkiewicz M" first="Magdalena" last="Benetkiewicz">Magdalena Benetkiewicz</name><name sortKey="Bonnetain, Franck" sort="Bonnetain, Franck" uniqKey="Bonnetain F" first="Franck" last="Bonnetain">Franck Bonnetain</name><name sortKey="Bonnetain, Franck" sort="Bonnetain, Franck" uniqKey="Bonnetain F" first="Franck" last="Bonnetain">Franck Bonnetain</name><name sortKey="Chibaudel, Benoist" sort="Chibaudel, Benoist" uniqKey="Chibaudel B" first="Benoist" last="Chibaudel">Benoist Chibaudel</name><name sortKey="Chibaudel, Benoist" sort="Chibaudel, Benoist" uniqKey="Chibaudel B" first="Benoist" last="Chibaudel">Benoist Chibaudel</name><name sortKey="Hammel, Pascal" sort="Hammel, Pascal" uniqKey="Hammel P" first="Pascal" last="Hammel">Pascal Hammel</name><name sortKey="Hammel, Pascal" sort="Hammel, Pascal" uniqKey="Hammel P" first="Pascal" last="Hammel">Pascal Hammel</name><name sortKey="Huguet, Florence" sort="Huguet, Florence" uniqKey="Huguet F" first="Florence" last="Huguet">Florence Huguet</name><name sortKey="Huguet, Florence" sort="Huguet, Florence" uniqKey="Huguet F" first="Florence" last="Huguet">Florence Huguet</name><name sortKey="Louvet, Christophe" sort="Louvet, Christophe" uniqKey="Louvet C" first="Christophe" last="Louvet">Christophe Louvet</name><name sortKey="Louvet, Christophe" sort="Louvet, Christophe" uniqKey="Louvet C" first="Christophe" last="Louvet">Christophe Louvet</name><name sortKey="Mineur, Laurent" sort="Mineur, Laurent" uniqKey="Mineur L" first="Laurent" last="Mineur">Laurent Mineur</name><name sortKey="Paget Bailly, Sophie" sort="Paget Bailly, Sophie" uniqKey="Paget Bailly S" first="Sophie" last="Paget-Bailly">Sophie Paget-Bailly</name><name sortKey="Vienot, Angelique" sort="Vienot, Angelique" uniqKey="Vienot A" first="Angélique" last="Vienot">Angélique Vienot</name></country><country name="Australie"><noRegion><name sortKey="Goldstein, David" sort="Goldstein, David" uniqKey="Goldstein D" first="David" last="Goldstein">David Goldstein</name></noRegion><name sortKey="Goldstein, David" sort="Goldstein, David" uniqKey="Goldstein D" first="David" last="Goldstein">David Goldstein</name></country><country name="Belgique"><noRegion><name sortKey="Van Laethem, Jean Luc" sort="Van Laethem, Jean Luc" uniqKey="Van Laethem J" first="Jean-Luc" last="Van Laethem">Jean-Luc Van Laethem</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Glimelius, Bengt" sort="Glimelius, Bengt" uniqKey="Glimelius B" first="Bengt" last="Glimelius">Bengt Glimelius</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Moore, Malcolm J" sort="Moore, Malcolm J" uniqKey="Moore M" first="Malcolm J" last="Moore">Malcolm J. 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