scholarly journals Development and validation of prognostic nomograms for patients with colon neuroendocrine neoplasms

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ruitong Xu ◽  
Bingrong Zhou ◽  
Ping Hu ◽  
Bingyan Xue ◽  
Danyang Gu ◽  
...  
Keyword(s):  
Tnm Classification ◽  
Age Groups ◽  
Staging System ◽  
Tnm Staging ◽  
Superior Performance ◽  
Neuroendocrine Neoplasms ◽  
Cancer Specific Survival ◽  
Size Grade ◽  
Precise Prediction ◽  
Development And Validation

Abstract Background Colon neuroendocrine neoplasms (NENs) have one of the poorest median overall survival (OS) rates among all NENs. The American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) staging system—currently the most commonly used prediction model—has limited prediction accuracy because it does not include parameters such as age, sex, and treatment. The aim of this study was to construct nomograms containing various clinically important parameters to predict the prognosis of patients with colon NENs more accurately. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, we performed a retrospective analysis of colon NENs diagnosed from 1975 to 2016. Data were collected from 1196 patients; almost half were female (617/1196, 51.6%), and the average age was 61.94 ± 13.05 years. Based on the age triple cut-off values, there were 396 (33.1%), 408 (34.1%), and 392 (32.8%) patients in age groups 0–55 years, 55–67 years, and ≥ 68 years, respectively. Patients were randomized into training and validation cohorts (3:1). Independent prognostic factors were used for construction of nomograms to precisely predict OS and cancer-specific survival (CSS) in patients with colon NENs. Results Multivariate analysis showed that age ≥ 68 years, sex, tumor size, grade, chemotherapy, N stage, and M stage were independent predictors of OS. In the validation cohort, the Concordance index (C-index) values of the OS and CSS nomograms were 0.8345 (95% confidence interval [CI], 0.8044–0.8646) and 0.8209 (95% CI, 0.7808–0.861), respectively. C-index also indicated superior performance of both nomograms (C-index 0.8347 for OS and 0.8668 for CSS) compared with the AJCC TNM classification (C-index 0.7159 for OS and 0.7366 for CSS). Conclusions We established and validated new nomograms for more precise prediction of OS and CSS in patients with colon NENs to facilitate individualized clinical decisions.

scholarly journals Development and Validation of Prognostic Nomograms for Patients with Colon Neuroendocrine NeoplasmsPrognostic Nomograms for Colon Nens’ Patients

2021 ◽  
Author(s):  
Ruitong Xu ◽  
Bingrong Zhou ◽  
Ping Hu ◽  
Bingyan Xue ◽  
Danyang Gu ◽  
...  
Keyword(s):  
Tnm Classification ◽  
Staging System ◽  
Tnm Staging ◽  
Superior Performance ◽  
Neuroendocrine Neoplasms ◽  
Cancer Specific Survival ◽  
Size Grade ◽  
Precise Prediction ◽  
N Stage ◽  
Development And Validation

Abstract Background Colon neuroendocrine neoplasms (NENs) have one of the poorest median overall survival (OS) rates among all NENs. The American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) staging system—currently the most commonly used prediction model—has limited prediction accuracy because it does not include parameters such as age, sex, and treatment. The aim of this study was to construct nomograms containing various clinically important parameters to predict the prognosis of patients with colon NENs more accurately. Methods Using the Surveillance, Epidemiology and End Results (SEER) database, we performed a retrospective analysis of colon NENs diagnosed from 1975 to 2016. Data were collected from 1196 patients, most of which were female (617/1196, 51.6%), and the average age was 61.94 ± 13.05 years old. Based on the optimal cutoff value in age (age 0–55 y, 55–67 y, age ≥ 68 y), 396 (33.1%) patients were between 0–55 y, 408 (34.1%) were between 56–67 y and 392 (32.8%) were ≥ 68 y. Patients were randomized into training and validation cohorts (3:1). Independent prognostic factors were used for construction of nomograms to precisely predict OS and cancer-specific survival (CSS) in patients with colon NENs. Results Multivariate analysis showed that age ≥ 68 years, sex, tumor size, grade, chemotherapy, N stage, and M stage were independent predictors of OS. In the validation cohort, the Concordance index (C-index) values of the OS and CSS nomograms were 0.8345 (95% confidence interval [CI], 0.8044–0.8646) and 0.8209 (95% CI, 0.7808–0.861), respectively. C-index also indicated superior performance of both nomograms (C-index 0.8347 for OS and 0.8668 for CSS) compared with the AJCC TNM classification (C-index 0.7159 for OS and 0.7366 for CSS). Conclusions We established and validated new nomograms for more precise prediction of OS and CSS in patients with colon NENs to facilitate individualized clinical decisions.

scholarly journals A convenient clinical nomogram for predicting the cancer-specific survival of individual patients with small-intestine adenocarcinoma

2020 ◽  
Author(s):  
Na Wang ◽  
Jin Yang ◽  
Jun Lyu ◽  
Qingqing Liu ◽  
Hairong He ◽  
...  
Keyword(s):  
Small Intestine ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Survival Rates ◽  
Discrimination Performance ◽  
Staging System ◽  
Tnm Staging ◽  
Superior Performance ◽  
Cancer Specific Survival ◽  
Net Reclassification Improvement

Abstract Background: The objective of this study was to develop a practical nomogram for predicting the cancer-specific survival (CSS) of patients with small-intestine adenocarcinoma. Methods: Patients diagnosed with small-intestine adenocarcinoma. between 2010 and 2015 were selected for inclusion in this study from the Surveillance, Epidemiology, and End Results (SEER) database. The selected patients were randomly divided intothe training and validation cohorts at a ratio of 7:3.The predictors of CSS were identified by applying both forward and backward stepwise selection methods in a Cox regression model. The performance of the nomogram was measured by the concordance index (C-index), the area under receiver operating characteristic curve (AUC), calibration plots, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and decision-curve analysis (DCA). Results: Multivariate Cox regression indicated that factors including age at diagnosis, sex, marital status, insurance status, histology grade, SEER stage, surgery status, T stage, and N stage were independent covariates associated with CSS. These factors were used to construct a predictive model, which was built and virtualized by a nomogram. The C-index of the constructed nomogram was 0.858. The AUC values indicated that the established nomogram displayed better discrimination performance than did the seventh edition of the American Joint Committee on Cancer TNM staging system in predicting CSS. The IDI and NRI also showed that the nomogram exhibited superior performance in both the training and validation cohorts. Furthermore, the calibrated nomogram predicted survival rates that closely corresponded to actual survival rates, while the DCA demonstrated the considerable clinical usefulness of the nomogram. Conclusion: We have constructed a nomogram for predicting the CSS of small-intestine adenocarcinoma patients. This prognostic model may improve the ability of clinicians to predict survival in individual patients and provide them with treatment recommendations.

scholarly journals A convenient clinical nomogram for predicting the cancer-specific survival of individual patients with small-intestine adenocarcinoma

2020 ◽  
Author(s):  
Na Wang ◽  
Jin Yang ◽  
Jun Lyu ◽  
Qingqing Liu ◽  
Hairong He ◽  
...  
Keyword(s):  
Small Intestine ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Survival Rates ◽  
Discrimination Performance ◽  
Staging System ◽  
Tnm Staging ◽  
Superior Performance ◽  
Cancer Specific Survival ◽  
Net Reclassification Improvement

Abstract Background: The objective of this study was to develop a practical nomogram for predicting the cancer-specific survival (CSS) of patients with small-intestine adenocarcinoma . Methods: Patients diagnosed with small-intestine adenocarcinoma between 2010 and 2015 were selected for inclusion in this study from the Surveillance, Epidemiology, and End Results (SEER) database. The selected patients were randomly divided into the training and validation cohorts at a ratio of 7:3. The predictors of CSS were identified by applying both forward and backward stepwise selection methods in a Cox regression model . The performance of the nomogram was measured by the concordance index (C-index), the area under receiver operating characteristic curve (AUC) , calibration plots, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI) , and decision-curve analysis (DCA). Results: Multivariate Cox regression indicated that factors including age at diagnosis, sex, marital status, insurance status, histology grade, SEER stage, surgery status, T stage, and N stage were independent covariates associated with CSS. These factors were used to construct a predictive model, which was built and virtualized by a nomogram. The C-index of the constructed nomogram was 0.850. The AUC values indicated that the established nomogram displayed better discrimination performance than did the seventh edition of the American Joint Committee on Cancer TNM staging system in predicting CSS. The IDI and NRI also showed that the nomogram exhibited superior performance in both the training and validation cohorts. Furthermore, the calibrated nomogram predicted survival rates that closely corresponded to actual survival rates, while the DCA demonstrated the considerable clinical usefulness of the nomogram. Conclusion: We have constructed a nomogram for predicting the CSS of small-intestine adenocarcinoma patients . This prognostic model may improve the ability of clinicians to predict survival in individual patients and provide them with treatment recommendations.

scholarly journals A convenient clinical nomogram for predicting the cancer-specific survival of individual patients with small-intestine adenocarcinoma

2020 ◽  
Author(s):  
Na Wang ◽  
Jin Yang ◽  
Jun Lyu ◽  
Qingqing Liu ◽  
Hairong He ◽  
...  
Keyword(s):  
Small Intestine ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Survival Rates ◽  
Discrimination Performance ◽  
Staging System ◽  
Tnm Staging ◽  
Superior Performance ◽  
Cancer Specific Survival ◽  
Net Reclassification Improvement

Abstract Background: The objective of this study was to develop a practical nomogram for predicting the cancer-specific survival (CSS) of patients with small-intestine adenocarcinoma. Methods: Patients diagnosed with small-intestine adenocarcinoma between 2010 and 2015 were selected for inclusion in this study from the Surveillance, Epidemiology, and End Results (SEER) database. The selected patients were randomly divided into the training and validation cohorts at a ratio of 7:3. The predictors of CSS were identified by applying both forward and backward stepwise selection methods in a Cox regression model. The performance of the nomogram was measured by the concordance index (C-index), the area under receiver operating characteristic curve (AUC), calibration plots, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and decision-curve analysis (DCA).Results: Multivariate Cox regression indicated that factors including age at diagnosis, sex, marital status, insurance status, histology grade, SEER stage, surgery status, T stage, and N stage were independent covariates associated with CSS. These factors were used to construct a predictive model, which was built and virtualized by a nomogram. The C-index of the constructed nomogram was 0.850. The AUC values indicated that the established nomogram displayed better discrimination performance than did the seventh edition of the American Joint Committee on Cancer TNM staging system in predicting CSS. The IDI and NRI also showed that the nomogram exhibited superior performance in both the training and validation cohorts. Furthermore, the calibrated nomogram predicted survival rates that closely corresponded to actual survival rates, while the DCA demonstrated the considerable clinical usefulness of the nomogram.Conclusion: We have constructed a nomogram for predicting the CSS of small-intestine adenocarcinoma patients. This prognostic model may improve the ability of clinicians to predict survival in individual patients and provide them with treatment recommendations.

Discrepancies between two staging systems (European-ENETS versus. American-AJCC) of neuroendocrine neoplasms of the pancreas: A study of 77 cases.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 318-318 ◽  
Author(s):  
Javier A. Cienfuegos ◽  
Joseba Salguero ◽  
Jorge Nuñez ◽  
Fernando Rotellar ◽  
Pablo Marti-Cruchaga ◽  
...  
Keyword(s):  
Tnm Classification ◽  
Cancer Control ◽  
Staging System ◽  
Tnm Staging ◽  
Neuroendocrine Neoplasms ◽  
Biological Behaviour ◽  
Term Survival ◽  
Female Ratio ◽  
Staging Systems ◽  
Male To Female

318 Background: Pancreatic neuroendocrine tumors (pNETs) comprise a spectrum of neoplasm with variable biological behaviour and heterogeneous prognosis. The European Neuroendocrine Tumor Society (ENETS) and the American Joint Cancer Committee/Union for International Cancer Control (AJCC/UICC) TNM staging systems have been recently published. The aim of this study was to evaluate the consistency of both staging systems on outcomes for patients with pNETs. Methods: A retrospective clinico-pathological study of 77 consecutive patients with pNETs who were surgically treated from 1993 to 2014 was carried out. Results: The male to female ratio was 1.0 (38 men, 39 women); 56 tumors were non-functionating and 21 functionating. Most of the tumors were G1 (57) and 20 were classified as G2-G3. The AJCC/UICC stage was IA in 29 patients, IB in 14, IIA in 10, IIB in 7 and IV in 17. Meanwhile, according with the ENETS staging system was: stage I in 30, IIa in 14, IIb in 3, IIIa in 6, IIIb in 7 and IV in 17. We found 18 (23.3%) cases of ENETS - AJCC/UICC discrepancies regarding the primary tumor. They included 6 cases (33%) disagreement between IIA (T3 N0 M0) and IIIa (T4 N0 M0); and 7 cases (38.8%) between IIB (T1-T3 N1 M0) and IIIb (anyT N1 M0). Conclusions: The AJCC and ENETS TNM classification staging for pNETs provide meaninful prognostic value of long-term survival por patients with pNETs. The T staging discrepancies between AJCC/UICC and ENETS are relative frequent and should be strictly recognized.

Different View on Tumor Size Dilemma in Tumor-Node-Metastasis Staging System for Thymoma

2020 ◽  
Author(s):  
Ayten Kayı Cangir ◽  
Bülent Mustafa Yenigün ◽  
Tamer Direk ◽  
Gokhan Kocaman ◽  
Ugurum Yücemen ◽  
...  
Keyword(s):  
Tumor Size ◽  
Tnm Classification ◽  
Staging System ◽  
Tnm Staging ◽  
R0 Resection ◽  
Tumor Diameter ◽  
Tumor Node Metastasis ◽  
Node Metastasis ◽  
The Mean ◽  
Definition Of

Abstract Background Although tumor size is included in the definition of T descriptor in the tumor-node-metastasis (TNM) classification of many solid tumors, it is not considered for thymomas. This study aimed to assess the relationship of tumor diameters (the largest tumor diameter [LTD] and the mean tumor diameter [MTD]) with survival in thymoma patients undergoing surgical resection in a single center. Methods The study included 127 thymoma patients (age, 49.2 ± 15.2 years; 65 males), who were evaluated based on pathological tumor sizes according to the LTD and MTD ([largest diameter + shortest diameter] / 2) and divided into three subgroups for each parameter as: patients with an LTD of ≤5 cm, 5.1 to 10 cm, and >10 cm and patients with an MTD of ≤5, 5.1 to 10, and >10 cm. Results In thymoma patients, survival significantly differed according to the presence of myasthenia gravis (p = 0.018), resection status (R0 or R1; p = 0.001), T status (p = 0.015), and the Masaoka–Koga stage (p = 0.003). In the LTD subgroups, the overall survival of those with R0 resection was lower in those with an LTD of 5.1 to 10 cm than in those with an LTD of ≤5 cm (p = 0.051) and significantly lower in those with an MTD of 5.1 to 10 cm than in those with an MTD of ≤5 cm (p = 0.027). In the MTD subgroups, survival decreased as the tumor size increased. Conclusion Both smaller tumor size and complete resection are associated with better survival in thymoma patients. Therefore, the largest or the mean tumor size might be considered as a criterion in the TNM staging for thymoma.

scholarly journals A Model for the Prediction of Survival in Patients With Upper Tract Urothelial Carcinoma After Surgery

Dose-Response ◽  
2019 ◽  
Vol 17 (4) ◽  
pp. 155932581988287
Author(s):  
Guang-lin Zhang ◽  
Wei Zhou
Keyword(s):  
Urothelial Carcinoma ◽  
Predictive Ability ◽  
Staging System ◽  
Tnm Staging ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Upper Tract ◽  
Tnm Staging System ◽  
Prediction Of Survival ◽  
Validation Set

Objective: We aimed to formulate and validate prognostic nomograms that can be used to predict the prognosis of patients with upper tract urothelial carcinoma (UTUC). Methods: By consulting the Surveillance, Epidemiology, and End Results (SEER) database, we identified patients who were surgically treated for UTUC between 2004 and 2013. Variables were analyzed in both univariate and multivariate analyses. Nomograms were constructed based on independent prognostic factors. The prognostic nomogram models were established and validated internally and externally to determine their ability to predict the survival of patients with UTUC. Results: A total of 4990 patients were collected and enrolled in our analyses. Of these, 3327 patients were assigned to the training set and 1663 to the validation set. Nomograms were effectively applied to predict the 3- and 5-year survivals of patients with UTUC after surgery. The nomograms exhibited better accuracy for predicting overall survival (OS) and cancer-specific survival (CSS) than the tumor-node-metastasis (TNM) staging system and the SEER stage in both the training and validation sets. Calibration curves indicated that the nomograms exhibited high correlation to actual observed results for both OS and CSS. Conclusions: The nomogram models showed stronger predictive ability than the TNM staging system and the SEER stage. Precise estimates of the prognosis of UTUC might help doctors to make better treatment decisions.

Independent validation of the 2002 UICC TNM staging system for papillary renal cell carcinoma in a multicenter cohort

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5092-5092
Author(s):  
C. Wulfing ◽  
E. Herrmann ◽  
L. Trojan ◽  
A. Schrader ◽  
F. Becker ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Staging System ◽  
Tnm Staging ◽  
Cancer Specific Survival ◽  
Tnm Staging System

5092 Background: Papillary renal cell carcinoma (pRCC) is the second most malignant histologic subtype in nephrectomy specimens. To date, the most recognized staging system to stratify renal cancer patients is the 2002 UICC TNM classification system. Its accuracy for predicting patient outcome for pRCC is unknown. Methods: From ten urologic institutions in Germany follow-up data on 675 patients with pRCC were collected. In most cases histologic slides were available and central pathologic review was performed. The Kaplan-Meier method was used to derive the cumulative cancer-specific survival. For multivariate analysis of prognostic factors, a Cox regression analysis was performed. Results: 498 (74.1%) patients had organ-confined tumor stages (≤pT2). Synchronous distant metastases in the entire group occurred in 58 (8.7%) patients and 69 (11.2%) others developed metastatic disease during follow-up. Cancer-specific survival (CSS) was significantly related to TNM stage and histologic grading in univariate as well as in multivariate analysis (all p < 0.0001). 5-year CSS in pT1b tumors (90.0%) was significantly shorter compared to pT1a tumors (98.3%) (p = 0.017). Patients with ≥pT3 were at high risk for metastases (50.6%), while metastatic disease associated with ≤pT2 tumors occurred in 7.8% (p < 0.0001). Once metastatic disease was present, prognosis was poor (5-year CSS: 7.2%). Age was associated with a worse prognosis in the subgroup of ≥pT3 tumors in univariate (p = 0.026), but not in multivariate analysis. Conclusions: The 2002 UICC TNM staging system is applicable for pRCC. Clinical and radiologic follow-ups should be offered in frequent intervals to patients with venous thrombus and/or locally advanced disease. The role of age remains unclear, but should not be underestimated at risk stratification after tumor resection. No significant financial relationships to disclose.

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