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Nomogram predicting the risk of recurrence after curative‐intent resection of primary non‐metastatic gastrointestinal neuroendocrine tumors: An analysis of the U.S. Neuroendocrine Tumor Study Group
Author(s) -
Merath Katiuscha,
Bagante Fabio,
Beal Eliza W.,
LopezAguiar Alexandra G.,
Poultsides George,
Makris Eleftherios,
Rocha Flavio,
Kanji Zaheer,
Weber Sharon,
Fisher Alexander,
Fields Ryan,
Krasnick Bradley A.,
Idrees Kamran,
Smith Paula M.,
Cho Cliff,
Beems Megan,
Schmidt Carl R.,
Dillhoff Mary,
Maithel Shishir K,
Pawlik Timothy M.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24985
Subject(s) - nomogram , medicine , neuroendocrine tumors , oncology , gastroenterology , surgery
Background The risk of recurrence after resection of non‐metastatic gastro‐entero‐pancreatic neuroendocrine tumors (GEP‐NET) is poorly defined. We developed/validated a nomogram to predict risk of recurrence after curative‐intent resection. Methods A training set to develop the nomogram and test set for validation were identified. The predictive ability of the nomogram was assessed using c‐indices. Results Among 1477 patients, 673 (46%) were included in the training set and 804 (54%) in y the test set. On multivariable analysis, Ki‐67, tumor size, nodal status, and invasion of adjacent organs were independent predictors of DFS. The risk of death increased by 8% for each percentage increase in the Ki‐67 index (HR 1.08, 95% CI, 1.05‐1.10; P < 0.001). GEP‐NET invading adjacent organs had a HR of 1.65 (95% CI, 1.03‐2.65; P = 0.038), similar to tumors ≥3 cm (HR 1.67, 95% CI, 1.11‐2.51; P = 0.014). Patients with 1‐3 positive nodes and patients with >3 positive nodes had a HR of 1.81 (95% CI, 1.12‐2.87; P = 0.014) and 2.51 (95% CI, 1.50‐4.24; P < 0.001), respectively. The nomogram demonstrated good ability to predict risk of recurrence (c‐index: training set, 0.739; test set, 0.718). Conclusion The nomogram was able to predict the risk of recurrence and can be easily applied in the clinical setting.