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This prediction model for 3-year survival after resection in patients with pancreatic cancer was developed in 2015 in Amsterdam UMC (location AMC) and externally validated in 2019 in 3081 patients from 8 countries (USA, UK, Germany, Italy, Sweden, the Netherlands, Korea, Australia).
PubMed ID 31924432
PubMed ID 31924432
Research authors: van Roessel, S, Strijker, M, Steyerberg, EW, ..., Besselink, MG
Details
Formula
Study characteristics
Files & References
★★★★★
Model author
Model ID
1739
Version
1.17
Revision date
2020-01-15
Specialty
MeSH terms
Model type
Custom model
(Conditional)
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Additional information
BackgroundThe objective of this study was to validate and update the Amsterdam prediction model including tumor grade, lymph node ratio, margin status and adjuvant therapy, for prediction of overall survival (OS) after pancreatoduodenectomy for pancreatic cancer.
Methods
We included consecutive patients who underwent pancreatoduodenectomy for pancreatic cancer between 2000 and 2017 at 11 tertiary centers in 8 countries (USA, UK, Germany, Italy, Sweden, the Netherlands, Korea, Australia). Model performance for prediction of OS was evaluated by calibration statistics and Uno's C-statistic for discrimination. Validation followed the TRIPOD statement.
Results
Overall, 3081 patients (53% male, median age 66 years) were included with a median OS of 24 months, of whom 38% had N2 disease and 77% received adjuvant chemotherapy. Predictions of 3-year OS were fairly similar to observed OS with a calibration slope of 0.72. Statistical updating of the model resulted in an increase of the C-statistic from 0.63 to 0.65 (95% CI 0.64-0.65), ranging from 0.62 to 0.67 across different countries. The area under the curve for the prediction of 3-year OS was 0.71 after updating. Median OS was 36, 25 and 15 months for the low, intermediate and high risk group, respectively (P < 0.001).
Conclusions
This large international study validated and updated the Amsterdam model for survival prediction after pancreatoduodenectomy for pancreatic cancer. The model incorporates readily available variables with a fairly accurate model performance and robustness across different countries, while novel markers may be added in the future. The risk groups and web-based calculator www.pancreascalculator.com may facilitate use in daily practice and future trials.
Source:
van Roessel S, Strijker M, Steyerberg EW, et al. International validation and update of the Amsterdam model for prediction of survival after pancreatoduodenectomy for pancreatic cancer. European Journal of Surgical Oncology: the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2019.
Study Population
Total population size: 3081Males: {{ model.numberOfMales }}
Females: {{ model.numberOfFemales }}
Continuous characteristics
| Name | LL | Q1 | Median | Q3 | UL | Unit |
|---|---|---|---|---|---|---|
| Age | 59 | 66 | 72 | years |
Categorical characteristics
| Name | Subset / Group | Nr. of patients |
|---|---|---|
| Margin status | R0 | 1785 |
| R1 | 1296 | |
| N stage (8th edition) | N0 | 663 |
| N1 | 1251 | |
| N2 | 1167 | |
| Tumor grade | Grade I (well) | 192 |
| Grade II (moderately) | 1848 | |
| Grade III (poorly) | 1041 | |
| Adjuvant therapy | Yes | 2359 |
| No | 722 |
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Evidencio B.V. |
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Refer to Intended Use for instructions before use |
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Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands |
Related files
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Supporting Publications
| Title or description | Tags |
|---|---|
| Validation paper: van Roessel S, Strijker M, Steyerberg EW et al. International validation and update of the Amsterdam model for prediction of survival after pancreatoduodenectomy for pancreatic cancer. EJSO. 2019. | External validation Figure Internal validation Kaplan Meier plot Paper Peer review ROC curve Model updating Model coefficients Patient characteristics Tripod |
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Original paper: Tol JA, Brosens LA, van Dieren S et al. Impact of lymph node ratio on survival in patients with pancreatic and periampullary cancer. BJS. 2015
DOI:
10.1002/bjs.9709
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Dataset Internal validation Institute logo |
Estimated 3-years survival after pancreatoduodenectomy: ... %
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Estimated 3-years survival after pancreatoduodenectomy: %
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Conditional information
Result interpretation
How this model should be used:
This validated model calculates 3-year survival after resection in patients with pancreatic cancer.
Model performance:
Predictions of 3-year OS were fairly similar to observed OS with a calibration slope of 0.72. Statistical updating of the model resulted in an increase of the C-statistic from 0.63 to 0.65 (95% CI 0.64-0.65), ranging from 0.62 to 0.67 across different countries. The area under the curve for the prediction of 3-year OS was 0.71 after updating. Median OS was 36, 25 and 15 months for the low, intermediate and high risk group, respectively (P<0.001).
Source:
van Roessel S, Strijker M, Steyerberg EW, et al. International validation and update of the Amsterdam model for prediction of survival after pancreatoduodenectomy for pancreatic cancer. European Journal of Surgical Oncology: the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2019.
Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.
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