• Katiuscha Merath, Fabio Bagante, Eliza W Beal, Alexandra G Lopez-Aguiar, George Poultsides, Eleftherios Makris, Flavio Rocha, Zaheer Kanji, Sharon Weber, Alexander Fisher, Ryan Fields, Bradley A Krasnick, Kamran Idrees, Paula M Smith, Cliff Cho, Megan Beems, Carl R Schmidt, Mary Dillhoff, Shishir K Maithel, and Timothy M Pawlik.
• Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.
• J Surg Oncol. 2018 Apr 1; 117 (5): 868-878.

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 ≥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).ConclusionThe nomogram was able to predict the risk of recurrence and can be easily applied in the clinical setting.© 2018 Wiley Periodicals, Inc.

21 keywords...

hide…