Comprehensive conditional survival analysis of pancreatic signet ring cell carcinoma: chemotherapy's role and predictive model development using the SEER database.
Mingxu Yu1, Xiaodong Chen2, Zihao Zheng3
1Department of Hepatobiliary and pancreatic surgery, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou city, 325000, China.
Discover Oncology
|June 12, 2025
View abstract on PubMed
Summary
Chemotherapy improves early survival for pancreatic signet ring cell carcinoma (PSRCC) but has limited long-term benefits. A new nomogram aids personalized survival prediction for this rare cancer.
Area of Science:
- Oncology
- Cancer Research
- Survival Analysis
Background:
- Pancreatic signet ring cell carcinoma (PSRCC) is an aggressive pancreatic cancer subtype with poor prognosis.
- Limited evidence exists on the survival benefits of chemotherapy for PSRCC.
- Conditional survival (CS) analysis offers a dynamic perspective on prognosis.
Purpose of the Study:
- To assess the impact of chemotherapy on PSRCC survival using conditional survival (CS) analysis.
- To develop a predictive model integrating CS for personalized prognosis in PSRCC.
- To identify key prognostic factors influencing survival in PSRCC patients.
Main Methods:
- Analysis of 708 PSRCC patients from the SEER database (2000-2019).
- Propensity score matching (PSM) and Kaplan-Meier curves to evaluate chemotherapy effects.
- Development of a CS-integrated nomogram using RSF, LASSO, and Cox regression, validated by multiple metrics.
Main Results:
- Conditional survival probability declined rapidly, reaching 18% at year 1, 5% at year 3, and 3% at year 5.
- Chemotherapy significantly improved 1-year survival (30% vs. 8% without chemotherapy), but long-term survival rates converged.
- A CS-integrated nomogram incorporating age, tumor size, stage, site, surgery, and chemotherapy demonstrated strong predictive accuracy.
Conclusions:
- Chemotherapy provides significant early survival advantages for PSRCC patients, though long-term benefits are limited.
- The developed nomogram serves as a reliable tool for personalized survival prediction in PSRCC.
- Further validation of the nomogram in prospective studies is recommended.
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