Nomogram predicting the risk of recurrence after curative-intent resection of primary non-metastatic gastrointestinal neuroendocrine tumors: An analysis of the US Neuroendocrine Tumor Study Group

作者：Merath Katiuscha; Bagante Fabio; Beal Eliza W; Lopez Aguiar 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^*

来源：Journal of Surgical Oncology, 2018, 117(5): 868-878.

DOI：10.1002/jso.24985

• neuroendocrine tumors
• nomogram
• recurrence

BackgroundThe 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.
MethodsA training set to develop the nomogram and test set for validation were identified. The predictive ability of the nomogram was assessed using c-indices.
ResultsAmong 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 3cm (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).
ConclusionThe nomogram was able to predict the risk of recurrence and can be easily applied in the clinical setting.

• 出版日期2018-4-1