Shen et al reported a nomogram for evaluating a patient with cancer of the pancreatic head with suspected venous invasion. These can help to identify a patient who may benefit from more aggressive management. The authors are from Zhejiang University, The Second Military Medical University (Shanghai), Huazhong University of Science and Technology, the Chinese University of Hong Kong and affiliated hospitals.
Patient selection: cancer of the pancreatic head with suspected venous invasion, prior to surgery
Parameters:
(1) age in years, from 35 to 85 years
(2) length of tumor contact in cm, from 0 to 7 cm (presumably contact with vessels)
(3) type of venous abnormality
(4) lymph node staging
points for age
= (1.93 * (age)) - 67.55
points for length of tumor contact in cm =
= 11.29 * (length in cm)
|
Parameter
|
Findiing
|
Points
|
|
type of vascular abnormality
|
Type 1 (none)
|
0
|
|
|
Type 2 (mild deformity or teardrop)
|
21
|
|
|
Type 3 (tethering or stenosis > 50%)
|
54.6
|
|
|
Type 4 (obstructing or embolus)
|
100
|
|
lymph node stage
|
N0
|
0
|
|
|
N1
|
28.5
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 304
• The higher the score the worse the overall survival.
value of X =
= (-0.00009034 * ((score)^2)) - (0.007805 * (score)) +3.269
probability of 12-month overall survival =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.824.
