An online web-based application smartphone compatible was developed that provides individualised survival estimates from the nomogram. For example, a patient with the following characteristics–63 years old (26 points), tumour measurement equal to 105 mm (53 points), albumin at 40.9 g l−1 (46 points), CA 19-9 at 89 (log-value=1.95 39 points) and the presence of pain at baseline clinical exam (16 point) will have a total points of 180, which corresponds to 6-, 12-, 24- and 48-month-survival probabilities of 80% (95% CI 71–86), 40% (95% CI 25–55), 7% (95% CI 2–17) and 1% (95% CI 0–4) and a predicted median survival time of 10.5 months (95% CI 8.75–13.5). A line is drawn down to read the corresponding predictions of 6-, 12-, 24- and 48-month-survival probability and median survival time. The total sum of points for four risk factors is plotted on the ‘total points’ line. Points are assigned for each risk factor by drawing a line upward from the corresponding values to the ‘point’ line. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future.British Journal of Cancer advance online publication 12 July 2016 doi:10.1038/bjc.2016.212 Prognostic nomogram to predict individual overall survival probability in patients with locally advanced pancreatic cancer. The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. The score ability to discriminate OS was externally confirmed in 63 (59%) patients with complete clinical data derived from a data set of 106 consecutive LAPC patients median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank P<0.0001). The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank P<0.0001). The final model had good calibration, acceptable discrimination (C-index=0.60) and robust internal validity. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besançon Hospital, France.Īge, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. Performance assessment and internal validation of the final model were done with Harrell's C-index, calibration plot and bootstrap sample procedures. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP).Īnalyses were derived from 442 LAPC patients enrolled in the LAP07 trial. Better discrimination for overall survival (OS) at diagnosis is needed. The management of locally advanced pancreatic cancer (LAPC) patients remains controversial.