TY - JOUR
T1 - Contemporary challenges in long-term survival prediction in resected pancreatic ductal adenocarcinoma
T2 - a transatlantic multicenter development and validation of prognostic models
AU - Javed, Ammar A.
AU - Ali, Mahsoem
AU - Mahmud, Omar
AU - Casciani, Fabio
AU - Andel, Paul C.M.
AU - Habib, Joseph R.
AU - Marchetti, Alessio
AU - Rompen, Ingmar F.
AU - van Goor, Iris W.J.M.
AU - Stoop, Thomas F.
AU - Mughal, Nabiha A.
AU - Schouten, Thijs J.
AU - Lafaro, Kelly
AU - Burkhart, Richard A.
AU - Burns, William R.
AU - Malleo, Giuseppe
AU - van Santvoort, Hjalmar C.
AU - den Dulk, Marcel
AU - Daams, Freek
AU - Mieog, Jan Sven D.
AU - Stommel, Martijn W.J.
AU - Patijn, Gijs A.
AU - de Hingh, Ignace
AU - Festen, Sebastiaan
AU - Nijkamp, Maarten W.
AU - Klaase, Joost M.
AU - Lips, Daan J.
AU - Wijsman, Jan H.
AU - van der Harst, Erwin
AU - Manusama, Eric
AU - van Eijck, Casper H.J.
AU - Groot Koerkamp, Bas
AU - Busch, Olivier R.
AU - Molenaar, Izaak Quintus
AU - Kazemier, Geert
AU - Salvia, Roberto
AU - Daamen, Lois A.
AU - He, Jin
AU - Wolfgang, Christopher L.
AU - Besselink, Marc G.
N1 - Publisher Copyright:
© 2026 International Hepato-Pancreato-Biliary Association Inc.
PY - 2026/7
Y1 - 2026/7
N2 - Background: Predicting long-term survival (>5 years; LTS) in resected pancreatic ductal adenocarcinoma (PDAC) remains challenging. The aim of this study was to train and evaluate LTS prediction models. Methods: We retrospectively included patients with PDAC who underwent resection between 2012 and 2019 from the databases at New York University, the Johns Hopkins Hospital, University of Verona Hospital Trust, and the Dutch Pancreatic Cancer Group. Two models were developed for the (1) post-operative and (2) post-adjuvant treatment phase. Training involved the full dataset followed by internal-external cross validation. Results: 4084 patients with resected PDAC were included. The estimated rate of LTS in (1) was 22% (95% CI: 21–24%) and in (2) 24% (95% CI: 22–26%). For model (1) 5-year performance metrics were an AUC of 0.68 (0.60–0.75), O/E ratio of 0.91 (0.45–1.82), and slope of 1.07 (0.56–2.05). Model (2) achieved 5-year AUC of 0.70 (0.64–0.75), O/E ratio of 0.96 (0.60–1.54), and slope of 1.16 (0.60–1.23). Conclusions: Our models achieved only modest performance despite a large, granular dataset and rigorous statistical methods, demonstrating the need for novel prognostic biomarkers.
AB - Background: Predicting long-term survival (>5 years; LTS) in resected pancreatic ductal adenocarcinoma (PDAC) remains challenging. The aim of this study was to train and evaluate LTS prediction models. Methods: We retrospectively included patients with PDAC who underwent resection between 2012 and 2019 from the databases at New York University, the Johns Hopkins Hospital, University of Verona Hospital Trust, and the Dutch Pancreatic Cancer Group. Two models were developed for the (1) post-operative and (2) post-adjuvant treatment phase. Training involved the full dataset followed by internal-external cross validation. Results: 4084 patients with resected PDAC were included. The estimated rate of LTS in (1) was 22% (95% CI: 21–24%) and in (2) 24% (95% CI: 22–26%). For model (1) 5-year performance metrics were an AUC of 0.68 (0.60–0.75), O/E ratio of 0.91 (0.45–1.82), and slope of 1.07 (0.56–2.05). Model (2) achieved 5-year AUC of 0.70 (0.64–0.75), O/E ratio of 0.96 (0.60–1.54), and slope of 1.16 (0.60–1.23). Conclusions: Our models achieved only modest performance despite a large, granular dataset and rigorous statistical methods, demonstrating the need for novel prognostic biomarkers.
UR - https://www.scopus.com/pages/publications/105040662214
U2 - 10.1016/j.hpb.2026.04.453
DO - 10.1016/j.hpb.2026.04.453
M3 - Article
C2 - 42168042
AN - SCOPUS:105040662214
SN - 1365-182X
VL - 28
SP - 955
EP - 965
JO - HPB
JF - HPB
IS - 7
ER -