Jianwei Xie1, YaJun Zhao2, Yanbing Zhou3, Qingliang He4, Hankun Hao5, Xiantu Qiu6, Gang Zhao7, Yanchang Xu8, Fangqin Xue9, Jinping Chen10, Guoqiang Su11, Ping Li1, Chao-Hui Zheng1, Chang-Ming Huang1. 1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China. 2. West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, China. 3. Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China. 4. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. 5. Huashan Hospital, Fudan University, Shanghai, China. 6. Department of Gastrointestinal Surgery, The Affiliated Hospital of Putian University, Putian, China. 7. Renji Hospital, Shanghai Jiaotong University, Shanghai, China. 8. Fujian Medicine University Teaching Hospital, The First Hospital of Putian, Putian, China. 9. Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian, China. 10. Department of Gastrointestinal Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China. 11. Department of Gastrointestinal Surgery, Xiamen Cancer Center, First Affiliated Hospital of Xiamen University, Xiamen, China.
Abstract
PRÉCIS: We present a valid and reproducible nomogram that combined the TNM stage as well as the Ki-67 index and carcinoembryonic antigen levels; the nomogram may be an indispensable tool to help predict individualized risks of death and help clinicians manage patients with gastric neuroendocrine carcinoma. BACKGROUND: To analyze the long-term outcomes of patients with grade 3 GNEC who underwent curative surgery and investigated whether the combination of carcinoembryonic antigen (CEA) levels and Ki-67 index can predict the prognosis of patients with gastric neuroendocrine carcinoma (GNEC) and constructed a nomogram to predict patient survival. METHODS: In the training cohort, data were collected from 405 patients with GNEC after radical surgery at seven Chinese centers. A nomogram was constructed to predict long-term prognosis. Data for the validation cohort were collected from 305 patients. RESULTS: The 5-year overall survival (OS) was worse in the high CEA group than in the normal CEA group (40.5% vs. 55.2%, p = 0.013). The 5-year OS was significantly worse in the high Ki-67 index group than in the low Ki-67 index group (47.9% vs. 57.2%, p = 0.012). Accordingly, we divided the whole cohort into a KC(-) group (low Ki-67 index and normal CEA) and KC(+) group (high Ki-67 index and/or high CEA). The KC(+) group had a worse prognosis than the KC(-) group (64.6% vs. 46.8%, p < 0.001). KC(+) and the AJCC 8th stage were independent factors for OS. Then, we combined KC status and the AJCC 8th stage to establish a nomogram; the C-index and area under the curve (AUC) were higher for the nomogram than for the AJCC 8th stage (C-index: 0.660 vs. 0.635, p = 0.005; AUC: 0.700 vs. 0.675, p = 0.020). The calibration curve verified that the nomogram had a good predictive value, with similar findings in the validation groups. CONCLUSIONS: The nomogram based on KC status and the AJCC 8th stage predicted the prognosis of patients with GNEC well.
PRÉCIS: We present a valid and reproducible nomogram that combined the TNM stage as well as the Ki-67 index and carcinoembryonic antigen levels; the nomogram may be an indispensable tool to help predict individualized risks of death and help clinicians manage patients with gastric neuroendocrine carcinoma. BACKGROUND: To analyze the long-term outcomes of patients with grade 3 GNEC who underwent curative surgery and investigated whether the combination of carcinoembryonic antigen (CEA) levels and Ki-67 index can predict the prognosis of patients with gastric neuroendocrine carcinoma (GNEC) and constructed a nomogram to predict patient survival. METHODS: In the training cohort, data were collected from 405 patients with GNEC after radical surgery at seven Chinese centers. A nomogram was constructed to predict long-term prognosis. Data for the validation cohort were collected from 305 patients. RESULTS: The 5-year overall survival (OS) was worse in the high CEA group than in the normal CEA group (40.5% vs. 55.2%, p = 0.013). The 5-year OS was significantly worse in the high Ki-67 index group than in the low Ki-67 index group (47.9% vs. 57.2%, p = 0.012). Accordingly, we divided the whole cohort into a KC(-) group (low Ki-67 index and normal CEA) and KC(+) group (high Ki-67 index and/or high CEA). The KC(+) group had a worse prognosis than the KC(-) group (64.6% vs. 46.8%, p < 0.001). KC(+) and the AJCC 8th stage were independent factors for OS. Then, we combined KC status and the AJCC 8th stage to establish a nomogram; the C-index and area under the curve (AUC) were higher for the nomogram than for the AJCC 8th stage (C-index: 0.660 vs. 0.635, p = 0.005; AUC: 0.700 vs. 0.675, p = 0.020). The calibration curve verified that the nomogram had a good predictive value, with similar findings in the validation groups. CONCLUSIONS: The nomogram based on KC status and the AJCC 8th stage predicted the prognosis of patients with GNEC well.
Authors: Aurel Perren; Anne Couvelard; Jean-Yves Scoazec; Frederico Costa; Ivan Borbath; Gianfranco Delle Fave; Vera Gorbounova; David Gross; Ashley Grossma; Robert T Jense; Matthew Kulke; Kjell Oeberg; Guido Rindi; Halfdan Sorbye; Staffan Welin Journal: Neuroendocrinology Date: 2017-02-11 Impact factor: 4.914
Authors: H Sorbye; S Welin; S W Langer; L W Vestermark; N Holt; P Osterlund; S Dueland; E Hofsli; M G Guren; K Ohrling; E Birkemeyer; E Thiis-Evensen; M Biagini; H Gronbaek; L M Soveri; I H Olsen; B Federspiel; J Assmus; E T Janson; U Knigge Journal: Ann Oncol Date: 2012-09-11 Impact factor: 32.976