A nomogram for predicting overall survival of patients with pancreatic ductal adenocarcinoma (PDAC) who underwent radical pancreatoduodenectomy(R0)

Background: Hypercoagulation and malnutrition are characteristic pathophysiological changes of PDAC, which are intimately associated with cancer progression and prognosis. We aimed at integrating related indicators to build a nomogram model for providing individualized overall survival predictions for patients with PDAC who underwent radical pancreatoduodenectomy(R0) Method: Clinicopathological and survival data of 138 patients who met the inclusion criteria were retrospectively analyzed. A nomogram was built based on the regression formula of multivariate Cox analysis. calibration curves and the areas under the ROC curves (AUCs) were utilized to evaluate the predictive performance of the nomogram. Result: High-grade (HR:3.70; 95%CI: 1.51-3.82; P244.8(HR:2.13; 95%CI:1.05-3.45; P=0.033), FBG>3.50g/L(HR:2.10;95%CI: 1.04-3.09,P=0.008), DRR>1.1(HR:2.69; 95%CI:1.56-4.27 ;P<0.001) served as independent risk factors of poor overall survival of PDAC patients who underwent radical pancreatoduodenectomy(R0) .A nomogram model was constructed based on this result. The calibration curves fitted well to the ideal 45° line ，and the AUCs at 1 ,2 and 3 years were 0.713，0.777, 0.845 respectively. Conclusion: The nomogram established based on characteristic pathophysiological alterations of PDAC for the prediction of overall survival of patients who underwent radical pancreatoduodenectomy(R0) presented considerable predictive power and may facilitate prognostic risk stratification, optimizing therapeutic decision-making.