摘要Background:Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant tumor.Surgical resection is the most promising therapeutic strategy for PDAC,and how to improve the survival rate remains a vital key point.This study aimed to establish and validate a nomogram for predicting the prognosis of resected PDAC.Methods:A total of 174 patients with PDAC who underwent surgical resection at Lanzhou University Sec-ond Hospital and the First Affiliated Hospital of Zhengzhou University from January 2012 to July 2022 were enrolled.The clinicopathological characteristics and survival data were analyzed by R software(ver-sion 4.1.3).Univariate and multivariate Cox regression analyses were used to analyze the effects of clini-copathological characteristics on overall survival(OS).Results:Multivariate Cox regression showed that carbohydrate antigen 19-9(CA19-9)≥476 U/mL,car-bohydrate antigen 125(CA125)≥32 U/mL,fasting blood glucose(FBG)<6.86 mmol/L,aspartate amino-transferase(AST)≥107 U/L,positive surgical margin,and more than 4 cycles of postoperative chemother-apy were independent prognostic factors for OS.Patients were divided into the high-risk and low-risk groups based on the median risk score calculated by multivariate Cox regression analysis.Kaplan-Meier survival curves revealed that the 5-year survival rates of the high-risk and low-risk groups in the training cohort were 5.8%and 24.3%,respectively,and those in the validation cohort were 0 and 19.0%,respec-tively(P<0.05).Receiver operating characteristic(ROC)curve analysis revealed that area under the ROC curve(AUC)of the risk score in the training set and the validation set were 0.855 and 0.838,respectively.The C-indexes of the nomogram in the training set and validation set were 0.788(95%CI:0.745-0.831)and 0.773(95%CI:0.718-0.828),respectively.Conclusions:We developed a nomogram that predicts OS in patients with resected PDAC,and the val-idation results showed that the nomogram model had a strong predictive ability.Particularly,FBG<6.86 mmol/L and more than 4 cycles of postoperative chemotherapy can predict better OS of PDAC after surgery.