Prognostic nomogram for ampullary adenocarcinoma patients with liver metastasis: Results from SEER database and National Cancer Center of China

Author:

Zhang Xiaojie1ORCID,Guo Chunguang2,Sun Chongyuan2,Li Zefeng2,Chen Yingtai2,Che Xu2,Zhao Dongbing2

Affiliation:

1. Chinese Academy of Medical Sciences & Peking Union Medical College

2. Chinese Academy of Medical Sciences Cancer Institute and Hospital: Cancer Hospital Chinese Academy of Medical Sciences

Abstract

Abstract Background: The liver was the most common metastatic site in ampullary adenocarcinoma (AC) patients. This study aims to investigate the overall survival and to establish a prognostic nomogram for AC patients with liver metastasis. Methods:AC patients with liver metastasis were retrospectively reviewed in the National Cancer Center of China and SEER database. The Cox proportional hazard model was performed to determine the independent prognostic risk factors. Then the prognostic nomogram was established and the internal validation was performed to assess the predictive value of the model. In addition, the area under the receiver operating curve (ROC) curve (AUC) and decision curve analyses (DCA) were conducted to validate the nomogram model. Results: A total of 4305 AC patients in the SEER database and 237 AC patients in the National Cancer Center of China were initially retrieved. The overall incidence of liver metastasis in AC patients was 6.3% (132 patients). Overall, the 1-year, 2-year and 5-year OS in AC patients with liver metastasis were 31.2%, 18.0%, and 4.3%. The survival analysis demonstrated that age [HR: 1.536, 95%CI: 1.031-2.289, P = 0.035], poor differentiation [HR: 2.320, 95%CI: 1.156-4.655, P=0.018] were independent risk factors for OS. Based on this, a prognostic nomogram was established. The C-index for the internal validation was 0.677. The internal calibration curve, ROC curve (AUC: 0.714), and DCA curve showed relatively good predictive ability of the current nomogram. Conclusions: The prognosis for AC patients with liver metastasis were poor. A prognostic overall survival nomogram for AC patients with liver metastasis was established and showed relatively good predictive ability. Nevertheless, further prospective studies with large sample are needed to validate our results.

Publisher

Research Square Platform LLC

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