Log odds of positive lymph nodes classification enhances survival predictions in duodenal adenocarcinoma, crucial for surgical decision-making.

• Standardized log odds showed strong predictive accuracy: c-index of 0.639 in a U.S. cohort and 0.679 in a Chinese cohort.
• A nomogram incorporating log odds, age, T-stage, and treatment achieved a 5-year area under the curve of 0.735, indicating high individual survival estimation accuracy.

Consider using the nomogram to refine patient selection and optimize treatment strategies based on accurate prognostic data.