医学
比例危险模型
队列
接收机工作特性
内科学
列线图
神秘的
逻辑回归
肿瘤科
胰腺导管腺癌
无线电技术
胰腺癌
回顾性队列研究
放射科
癌症
病理
替代医学
作者
Ben Y. Zhao,Cong Xia,Tianyi Xia,Yudong Qiu,Lihong Zhu,Bo Cao,Guang Yin,Rongjun Ge,Wenli Cai,Zhijie Ding,Qian Yu,Chun-Qiang Lu,Tianyu Tang,Yuancheng Wang,Yang Song,Xueying Long,Jing Ye,Lü Dong,Shenghong Ju
标识
DOI:10.1097/js9.0000000000000908
摘要
Undetectable occult liver metastases block the long-term survival of pancreatic ductal adenocarcinoma (PDAC). This study aimed to develop a radiomics-based model to predict occult liver metastases and assess its prognostic capacity for survival.Patients who underwent surgical resection and were pathologically proven with PDAC were recruited retrospectively from five tertiary hospitals between January 2015 and December 2020. Radiomics features were extracted from tumors, and the radiomics-based model was developed in the training cohort using LASSO-logistic regression. The model's performance was assessed in the internal and external validation cohorts using the area under the receiver operating curve (AUC). Subsequently, the association of the model's risk stratification with progression-free survival (PFS) and overall survival (OS) was then statistically examined using Cox regression analysis and the log-rank test.A total of 438 patients [mean (SD) age, 62.0 (10.0) years; 255 (58.2%) male] were divided into the training cohort ( n =235), internal validation cohort ( n =100), and external validation cohort ( n =103). The radiomics-based model yielded an AUC of 0.73 (95% CI: 0.66-0.80), 0.72 (95% CI: 0.62-0.80), and 0.71 (95% CI: 0.61-0.80) in the training, internal validation, and external validation cohorts, respectively, which were higher than the preoperative clinical model. The model's risk stratification was an independent predictor of PFS (all P <0.05) and OS (all P <0.05). Furthermore, patients in the high-risk group stratified by the model consistently had a significantly shorter PFS and OS at each TNM stage (all P <0.05).The proposed radiomics-based model provided a promising tool to predict occult liver metastases and had a great significance in prognosis.
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