OBJECTIVE: Neuroendocrine tumors (NETs) comprise 41.8% of small intestine malignancies. The NET nomogram is a 15-item prognostic tool that includes relevant factors for guiding management decisions. This is the first external validation of this tool among American patients at a tertiary treatment center. METHODS: Patients who underwent surgical intervention from 2005 to 2017 were screened by retrospective chart review. Nomogram scores were calculated following the methods outlined by Modlin et al (Neuroendocrinology. 2010;92:143-157). Validation assessed the association between nomogram scores and survival using Wilcoxon test and Cox regression. RESULTS: Among the 121 patients selected, the NET nomogram significantly predicted survival as a continuous variable (P < 0.01) and when dichotomized using 83 points to distinguish low-risk versus high-risk groups (P < 0.01). However, the nomogram was not universally applicable as even at our specialty center, variables such as chromogranin A and urinary 5-hydroxyindoleacetic acid are not routinely collected, whereas others, like tumor grade, do not reflect the most recently updated classifications. CONCLUSION: The NET nomogram accurately identified patients at low and high risk of death. However, revision to update prognosticators could improve its usefulness for predicting survival of small intestine NETs.
OBJECTIVE:Neuroendocrine tumors (NETs) comprise 41.8% of small intestine malignancies. The NET nomogram is a 15-item prognostic tool that includes relevant factors for guiding management decisions. This is the first external validation of this tool among American patients at a tertiary treatment center. METHODS:Patients who underwent surgical intervention from 2005 to 2017 were screened by retrospective chart review. Nomogram scores were calculated following the methods outlined by Modlin et al (Neuroendocrinology. 2010;92:143-157). Validation assessed the association between nomogram scores and survival using Wilcoxon test and Cox regression. RESULTS: Among the 121 patients selected, the NET nomogram significantly predicted survival as a continuous variable (P < 0.01) and when dichotomized using 83 points to distinguish low-risk versus high-risk groups (P < 0.01). However, the nomogram was not universally applicable as even at our specialty center, variables such as chromogranin A and urinary 5-hydroxyindoleacetic acid are not routinely collected, whereas others, like tumor grade, do not reflect the most recently updated classifications. CONCLUSION: The NET nomogram accurately identified patients at low and high risk of death. However, revision to update prognosticators could improve its usefulness for predicting survival of small intestine NETs.
Authors: Niko Hiltunen; Jukka Rintala; Juha P Väyrynen; Jan Böhm; Tuomo J Karttunen; Heikki Huhta; Olli Helminen Journal: Cancers (Basel) Date: 2022-05-22 Impact factor: 6.575
Authors: Praveen D Chatani; John G Aversa; James D McDonald; Tahsin M Khan; Xavier M Keutgen; Naris Nilubol Journal: Surgery Date: 2021-04-02 Impact factor: 4.348
Authors: M Tarquini; M R Ambrosio; M Albertelli; P B de Souza; R Gafà; I Gagliardi; A Carnevale; P Franceschetti; M C Zatelli Journal: J Endocrinol Invest Date: 2020-09-06 Impact factor: 4.256
Authors: Jhean Gabriel Gonzáles-Yovera; Pela J Roseboom; Marcio Concepción-Zavaleta; Isamar Gutiérrez-Córdova; Esteban Plasencia-Dueñas; María Quispe-Flores; Anthony Ramos-Yataco; Carlos Alcalde-Loyola; Frederick Massucco-Revoredo; José Paz-Ibarra; Luis Concepción-Urteaga Journal: World J Methodol Date: 2022-09-20