Abstract
BackgroundThis study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs).MethodsWe retrospectively analysed 310 patients with rectal neuroendocrine tumours in 5 hospitals in southern China. All of the patients were assigned to the training set. A multivariable analysis using Cox proportional hazards regression was performed using the training set, and a nomogram was constructed. It was validated on a dataset obtained from the Surveillance, Epidemiology, and End Result (SEER) database of America (n = 547).ResultsIn the training set, the nomogram exhibited improved discrimination power compared with the WHO grade guidelines (Herrell’s C-index, 0.872 vs 0.794; p < 0.001) and was also better than the seventh AJCC TNM classification (Herrell’s C-index, 0.872 vs 0.817; p < 0.001). In the SEER validation dataset, the discrimination was also excellent (C-index, 0.648 vs 0.583, p < 0.001 and 0.648 vs 0.603, p = 0.016, respectively, compared with G grade and TNM classification). Calibration of the nomogram predicted individual survival corresponding closely with the actual survival.ConclusionsWe developed a nomogram predicting 1- and 3-year OS of patients with rectal neuroendocrine tumours. Validation revealed excellent discrimination and calibration, suggesting good clinical utility.
Highlights
This study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs)
The most commonly used predictive systems for NETs are the American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumour Society (ENETS) Tumour Node Metastasis (TNM) staging systems or the WHO grade guidelines, which are based on the mitotic count and Ki67 proliferative index
Materials and methods We retrospectively analysed the data of 442 patients with rectal NETs who were treated in 5 hospitals in southern China
Summary
This study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs). The incidence of NETs has been increasing [1, 2]. Outcomes of patients with rectal NETs remain uncertain. The most commonly used predictive systems for NETs are the AJCC and the European Neuroendocrine Tumour Society (ENETS) TNM staging systems or the WHO grade guidelines, which are based on the mitotic count and Ki67 proliferative index. These systems lack other clinicopathological features that can influence outcomes such as age, sex, and tumour size. Our objective is to create a system that takes clinicopathological features into consideration, hoping it will provide a more accurate prognosis and have utility in clinical practice and medical decision making
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