Contemporary challenges in long-term survival prediction in resected pancreatic ductal adenocarcinoma: A transatlantic multicenter development and validation of prognostic models

Authors

• Ammar A. Javed, University of Amsterdam
• Mahsoem Ali, University of Amsterdam
• Omar Mahmud, Aga Khan UniversityFollow
• Fabio Casciani, University of Verona Hospital Trust
• Paul C M Andel, Regional Academic Cancer Center Utrecht
• Joseph R. Habib, The NYU Grossman School of Medicine and NYU Langone Health
• Alessio Marchetti, University of Verona Hospital Trust
• Ingmar F. Rompen, Heidelberg University Hospital
• Iris W J M van Goor, Regional Academic Cancer Center Utrecht
• Thomas F. Stoop, University of Amsterdam
• Nabiha A. Mughal, The NYU Grossman School of Medicine and NYU Langone Health
• Thijs J. Schouten, Regional Academic Cancer Center Utrecht
• Kelly Lafaro, Johns Hopkins University School of Medicine
• Richard A. Burkhart, Johns Hopkins University School of Medicine
• William R. Burns, Johns Hopkins University School of Medicine

Document Type

Article

Department

Medical College Pakistan

Abstract

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.

Comments

Volume, and issue ae not provided by the author/publisher.

Publication (Name of Journal)

HPB

DOI

10.1016/j.hpb.2026.04.453

Recommended Citation

Javed, A. A., Ali, M., Mahmud, O., Casciani, F., Andel, P. C., Habib, J. R., Marchetti, A., Rompen, I. F., Goor, I. J., Stoop, T. F., Mughal, N. A., Schouten, T. J., Lafaro, K., Burkhart, R. A., Burns, W. R. (2026). Contemporary challenges in long-term survival prediction in resected pancreatic ductal adenocarcinoma: A transatlantic multicenter development and validation of prognostic models. HPB, 1-11.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/654