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Development and external validation of a machine learning-based model to predict postoperative recurrence in patients with duodenal adenocarcinoma: a multicenter, retrospective cohort study

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机构: [1]Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [2]National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [3]General Surgery, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Cancer Center, Hangzhou, Zhejiang, China. [4]Department of General Surgery, First Medical Center of Chinese, PLA General Hospital, Beijing, China. [5]Department of General Surgery, Peking University Third Hospital, Beijing, China. [6]Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China. [7]Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. [8]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China. [9]Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. [10]Hepatobiliary and Pancreatogastric Surgery, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China. [11]Department of General Surgery, Peking University First Hospital, Beijing, China. [12]Department of Hepatobiliary Surgery, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China. [13]Gastrointestinal Surgery Department, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China. [14]Department of Oncological Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. [15]Department of General Surgery, Beijing Hospital, Beijing, China. [16]General Surgery Department, Capital Medical University Beijing Affiliated Tiantan Hospital, Beijing, China. [17]General Surgery Department, Xuanwu Hospital, Capital Medical University, Beijing, China.
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关键词: Duodenal adenocarcinoma Cancer recurrence Surgery Machine learning-based model

摘要:
Duodenal adenocarcinoma (DA) has a high recurrence rate, making the prediction of recurrence after surgery critically important.Our objective is to develop a machine learning-based model to predict the postoperative recurrence of DA. We conducted a multicenter, retrospective cohort study in China. 1830 patients with DA who underwent radical surgery between 2012 and 2023 were included. Wrapper methods were used to select optimal predictors by ten machine learning learners. Subsequently, these ten learners were utilized for model development. The model's performance was validated using three separate cohorts, and assessed by the concordance index (C-index), time-dependent calibration curve, time-dependent receiver operating characteristic curves, and decision curve analysis.After selecting predictors, ten feature subsets were identified. And ten feature subsets were combined with the ten machine learning learners in a permutation, resulting in the development of 100 predictive models, and the Penalized Regression + Accelerated Oblique Random Survival Forest model (PAM) exhibited the best predictive performance. The C-index for PAM was 0.882 (95% CI 0.860-0.886) in the training cohort, 0.747 (95% CI 0.683-0.798) in the validation cohort 1, 0.736 (95% CI 0.649-0.792) in the validation cohort 2, and 0.734 (95% CI 0.674-0.791) in the validation cohort 3. A publicly accessible web tool was developed for the PAM.The PAM has the potential to identify postoperative recurrence in DA patients. This can assist clinicians in assessing the severity of the disease, facilitating patient follow-up, and aiding in the formulation of adjuvant treatment strategies.© 2025. The Author(s).

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大类 | 1 区 医学
小类 | 1 区 医学:内科
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大类 | 1 区 医学
小类 | 1 区 医学:内科
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Q1 MEDICINE, GENERAL & INTERNAL
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Q1 MEDICINE, GENERAL & INTERNAL

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第一作者机构: [2]National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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