ArticleGland surgery2021
A nomogram of preoperative predictors for occult metastasis in patients with PDAC during laparoscopic exploration.
Article in Gland surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 16 citations in OpenAlex.
- Developing an interpretable machine learning model via SHAP to predict HCC postoperative survival based on tumor immune microenvironment CODEX immunomics and MRI.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
- Development and validation of a risk prediction model for major postoperative adverse events in elderly colon cancer using firth regression: a large-scale retrospective study.Frontiers in oncology · 2026Article
- Preoperative MRI and CA19-9 for predicting occult lymph node metastasis in small pancreatic ductal adenocarcinoma (≤ 2 cm).BMC medical imaging · 2025Article
- The Difficulty of Detecting Occult Metastases in Patients with Potentially Resectable Pancreatic Cancer: Development and External Validation of a Preoperative Prediction Model.Journal of clinical medicine · 2024Article
- Survival for Patients with Radiographically Occult Metastatic Pancreatic Cancer in the Era of Modern Multiagent Chemotherapy.Annals of surgical oncology · 2023Article
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8 authors at 2 institutions in 1 country.
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Abstract
backgroundSurgical resection is the only potentially curative treatment for pancreatic ductal adenocarcinoma (PDAC). However, most of patients lose the chance of surgery due to the unresectable disease at the time of diagnosis. Despite the improvement of radiological imaging, a portion of patients intended for radical resection were proven to be unresectable at surgical exploration due to occult metastasis.
methodsPatients who were aimed to undergo radical pancreatectomy for PDAC from 2010 to 2019 were reviewed retrospectively. All patients included underwent diagnostic laparoscopic exploration. Patients were divided into two groups depending on whether distant metastasis were encountered during exploration. Univariate and multivariate logistic regression analyses were used to identify risk factors for occult metastasis. A nomogram to predict occult metastasis of PDAC on exploration was developed and evaluated.
resultsA total of 273 patients who underwent diagnostic laparoscopic exploration were included in this study. Nineteen (7.0%) patients were found with distant metastasis during exploration. Multivariate logistic regression analysis showed that ALT>40U/L, CA19-9, CA125 and regional nodes enlargement were independent predictors for occult metastasis. Incorporating these four factors, the nomogram achieved concordance index of 0.799, with a well-fitted calibration curve.
conclusionsOccult metastasis is not unusual during surgical exploration in patients with resectable or borderline resectable PDAC. The nomogram could achieve a personal prediction of unexpected distant metastasis on exploration. It may help to sift through patients with PDAC who would benefit from laparoscopic exploration.
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