Meaningful nomograms based on systemic immune inflammation index predicted survival in metastatic pancreatic cancer patients receiving chemotherapy

Cancer Med. 2024 Jul;13(13):e7453. doi: 10.1002/cam4.7453.

Abstract

Objective: The purpose of the study is to construct meaningful nomogram models according to the independent prognostic factor for metastatic pancreatic cancer receiving chemotherapy.

Methods: This study is retrospective and consecutively included 143 patients from January 2013 to June 2021. The receiver operating characteristic (ROC) curve with the area under the curve (AUC) is utilized to determine the optimal cut-off value. The Kaplan-Meier survival analysis, univariate and multivariable Cox regression analysis are exploited to identify the correlation of inflammatory biomarkers and clinicopathological features with survival. R software are run to construct nomograms based on independent risk factors to visualize survival. Nomogram model is examined using calibration curve and decision curve analysis (DCA).

Results: The best cut-off values of 966.71, 0.257, and 2.54 for the systemic immunological inflammation index (SII), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) were obtained by ROC analysis. Cox proportional-hazards model revealed that baseline SII, history of drinking and metastasis sites were independent prognostic indices for survival. We established prognostic nomograms for primary endpoints of this study. The nomograms' predictive potential and clinical efficacy have been evaluated by calibration curves and DCA.

Conclusion: We constructed nomograms based on independent prognostic factors, these models have promising applications in clinical practice to assist clinicians in personalizing the management of patients.

Keywords: chemotherapy; drinking; liver metastases; metastatic pancreatic cancer; nomogram; systemic immune–inflammation index.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Female
  • Humans
  • Inflammation* / immunology
  • Kaplan-Meier Estimate
  • Lymphocytes / immunology
  • Male
  • Middle Aged
  • Monocytes / immunology
  • Neoplasm Metastasis
  • Neutrophils / immunology
  • Nomograms*
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / immunology
  • Pancreatic Neoplasms* / mortality
  • Pancreatic Neoplasms* / pathology
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies