Predicting the survival of patients with small bowel neuroendocrine tumours: comparison of 3 systems
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Published version
Author(s)
Type
Journal Article
Abstract
Neuroendocrine tumours (NET) are clinically challenging due to their unpredictable behaviour. Nomograms, grading and staging systems are predictive tools with multiple roles in clinical practice, including patient prognostication. The NET nomogram allocates scores for various clinicopathological parameters, calculating percentage estimates for 5- and 10-year disease-specific survival of patients with small bowel (SB) NET. We evaluated the clinical utility of three prognostic systems in 70 SB NET patients: the NET nomogram, the World Health Organisation (WHO)/European Neuroendocrine Tumour Society (ENETS) grading system and the American Joint Commission on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) TNM staging method. Using Kaplan–Meier methodology, neither the WHO/ENETS grade (P = 0.6) nor the AJCC/UICC stage (P = 0.276) systems demonstrated significant differences in patient survival in the cohort. The NET nomogram was well calibrated to our data set, displaying favourable prediction accuracy. Harrel’s C-index for the nomogram (a measure of predictive power) was 0.65, suggesting good prediction ability. On Kaplan–Meier analyses, there were significant differences in patient survival when stratified into nomogram score-based risk groups: low-, medium- and high-risk tumours were associated with median estimated survivals of 156, 129 and 112 months, respectively (P = 0.031). Our data suggest that a multivariable analysis-based NET nomogram may be clinically useful for patient survival prediction. This study identifies the limitations of the NET nomogram and the imperfections of other currently used single or binary parameter methodologies for assessing neuroendocrine disease prognosis. The future addition of other variables to the NET nomogram will likely amplify the accuracy of this personalised tool.
Date Issued
2017-01-19
Date Acceptance
2017-01-19
Citation
Endocrine Connections, 2017, 6 (2), pp.71-81
ISSN
2049-3614
Publisher
BioScientifica
Start Page
71
End Page
81
Journal / Book Title
Endocrine Connections
Volume
6
Issue
2
Copyright Statement
© 2017 The authors. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
Sponsor
National Institute for Health Research
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000395906000004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
RDB04
Subjects
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
small bowel
neuroendocrine
tumour
nomogram
prediction
STAGING CLASSIFICATION
LIVER METASTASES
CARCINOID-TUMORS
CANCER
CONSENSUS
ONCOLOGY
NOMOGRAM
MIDGUT
TRANSPLANTATION
RECURRENCE
Publication Status
Published