ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1636715
This article is part of the Research TopicClinical prediction models in cancer through bioinformaticsView all 14 articles
Development and Validation of a Prognostic Nomogram for Unresectable Pancreatic Ductal Adenocarcinoma with Synchronous Liver Metastases: A Study Based on the SEER Database and an External Cohort
Provisionally accepted
- 1Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- 2Renji Hospital, School of Medicine, Chongqing University,, Chongqing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Pancreatic ductal adenocarcinoma with synchronous liver metastases (PDACLM) represents a highly aggressive malignancy with limited treatment options and poor prognosis. While conversion therapy may enable curative surgery in a small subset of patients, the majority ultimately remain ineligible for resection. Prognostic tools tailored to this unresected population are lacking but urgently needed for guiding clinical decisions.We conducted a retrospective cohort study using 9,469 patients with histologically confirmed PDACLM from the SEER database (2010-2015), supplemented by an external validation cohort of 94 patients treated at the Second Affiliated Hospital of Chongqing Medical University (2020-2023). Multivariate Cox regression analysis was used to identify independent prognostic factors. A nomogram was constructed and validated internally and externally to predict individualized overall survival (OS) at 12, 18, and 24 months.Age ≥65 years, higher tumor grade, and undetermined nodal status were independently associated with reduced OS, while chemotherapy, radiotherapy, and metastasis-directed surgery significantly improved survival outcomes (all P<0.05).The nomogram demonstrated good discriminative performance with a C-index of 0.73 in the training cohort and 0.72 in internal validation. External validation showed consistent predictive accuracy (C-index: 0.715). Calibration plots and decision curve analyses supported the model's reliability and clinical utility.We developed and externally validated a clinically accessible nomogram for survival prediction in unresected PDACLM patients. This tool may assist clinicians in risk stratification and treatment planning for a frequently overlooked patient subgroup.Further prospective validation is warranted to confirm its applicability in broader clinical settings.
Keywords: ：Pancreatic Ductal Adenocarcinoma, Synchronous liver metastases, Unresectable cancer, nomogram, prognostic factors
Received: 28 May 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Huan, He, Cao, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yue Li, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.