Development and External Validation of Survival Prediction Model for Pancreatic Cancer Using Two Nationwide Databases: Surveillance, Epidemiology and End Results (SEER) and Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP)
Jae Seung Kang,
Lydia Mok,
Jin Seok Heo,
In Woong Han,
Sang Hyun Shin,
Yoo-Seok Yoon,
Ho-Seong Han,
Dae Wook Hwang,
Jae Hoon Lee,
Woo Jung Lee,
Sang Jae Park,
Joon Seong Park,
Yonghoon Kim,
Huisong Lee,
Young-Dong Yu,
Jae Do Yang,
Seung Eun Lee,
Il Young Park,
Chi-Young Jeong,
Younghoon Roh,
Seong-Ryong Kim,
Ju Ik Moon,
Sang Kuon Lee,
Hee Joon Kim,
Seungyeoun Lee,
Hongbeom Kim,
Wooil Kwon,
Chang-Sup Lim,
Jin-Young Jang,
Taesung Park
Affiliations
Jae Seung Kang
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
Lydia Mok
Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea
Jin Seok Heo
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
In Woong Han
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Sang Hyun Shin
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Yoo-Seok Yoon
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
Ho-Seong Han
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
Dae Wook Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jae Hoon Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Woo Jung Lee
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Sang Jae Park
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea
Joon Seong Park
Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Yonghoon Kim
Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
Huisong Lee
Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
Young-Dong Yu
Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
Jae Do Yang
Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
Seung Eun Lee
Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
Il Young Park
Department of General Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
Chi-Young Jeong
Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
Younghoon Roh
Department of Surgery, Dong-A University College of Medicine, Busan, Korea
Seong-Ryong Kim
Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
Ju Ik Moon
Department of Surgery, Konyang University Hospital, Daejeon, Korea
Sang Kuon Lee
Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
Hee Joon Kim
Department of Surgery, Chonnam National University Hospital, Gwangju, Korea
Seungyeoun Lee
Department of Mathematics and Statistics, Sejong University, Seoul, Korea
Hongbeom Kim
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Wooil Kwon
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Chang-Sup Lim
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
Jin-Young Jang
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Taesung Park
Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea
Background/Aims: Several prediction models for evaluating the prognosis of nonmetastatic resected pancreatic ductal adenocarcinoma (PDAC) have been developed, and their performances were reported to be superior to that of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. We developed a prediction model to evaluate the prognosis of resected PDAC and externally validated it with data from a nationwide Korean database. Methods: Data from the Surveillance, Epidemiology and End Results : (SEER) database were utilized for model development, and data from the Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP) database were used for external validation. Potential candidate variables for model development were age, sex, histologic differentiation, tumor location, adjuvant chemotherapy, and the AJCC 8th staging system T and N stages. For external validation, the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC) were evaluated. Results: Between 2004 and 2016, data from 9,624 patients were utilized for model development, and data from 3,282 patients were used for external validation. In the multivariate Cox proportional hazard model, age, sex, tumor location, T and N stages, histologic differentiation, and adjuvant chemotherapy were independent prognostic factors for resected PDAC. After an exhaustive search and 10-fold cross validation, the best model was finally developed, which included all prognostic variables. The C-index, 1-year, 2-year, 3-year, and 5-year time-dependent AUCs were 0.628, 0.650, 0.665, 0.675, and 0.686, respectively. Conclusions: The survival prediction model for resected PDAC could provide quantitative survival probabilities with reliable performance. External validation studies with other nationwide databases are needed to evaluate the performance of this model.
