Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital, School of Medicine, Xiamen University. Teaching Hospital of Fujian Medical University, Xiamen, China.
Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China.
ESMO Open. 2020 Apr;5(2). doi: 10.1136/esmoopen-2019-000632.
The prediction of survival of gastric neuroendocrine tumours (g-NETs) is controversial. Prognostic effects of the metastatic lymph node ratio (LNR) in patients with g-NET were explored, and a nomogram was plotted to predict the survival rates of patients.
A longitudinal study conducted on the basis of the Surveillance, Epidemiology, and End Results database. The association between LNR and survival were investigated by using Pearson correlation and Cox regression. Overall survival (OS) and cancer-specific survival (CSS) rates were predicted with the help of nomograms.
A total of 315 patients with g-NET diagnosed from 2004 to 2015 were included in this study. LNR was discovered to have a negative correlation with OS and CSS (Pearson correlation coefficients: 0.343 (p<0.001) and 0.389 (p<0.001), respectively). The multivariate analyses indicated age, tumour site, differentiation, T staging, M staging, chemotherapy and LNR to be independent prognostic factors for both OS and CSS. Surgery was also a prognostic determinant for CSS (p=0.003). Concordance indices of the nomograms for OS and CSS were higher than those of the TNM classification (0.772 vs 0.730 and 0.807 vs 0.768, respectively). As per the area under the receiver operating characteristic curve, predictive ability of the nomograms for survival of 1, 3 and 5 years was all better than that of TNM classification.
LNR is an independent predictor of g-NETs. The nomograms plotted in this study have a satisfying predictive ability of survival risks and are capable of guiding tailored treatment strategies for patients with g-NET.
胃神经内分泌肿瘤（g-NET）的生存预测存在争议。本研究旨在探讨转移性淋巴结比率（LNR）对 g-NET 患者预后的影响，并绘制列线图预测患者的生存率。
这是一项基于监测、流行病学和最终结果数据库的纵向研究。采用 Pearson 相关和 Cox 回归分析 LNR 与生存的关系。借助列线图预测总生存率（OS）和癌症特异性生存率（CSS）。
共纳入 2004 年至 2015 年间诊断的 315 例 g-NET 患者。LNR 与 OS 和 CSS 呈负相关（Pearson 相关系数分别为 0.343（p<0.001）和 0.389（p<0.001））。多因素分析显示，年龄、肿瘤部位、分化程度、T 分期、M 分期、化疗和 LNR 是 OS 和 CSS 的独立预后因素。手术也是 CSS 的预后决定因素（p=0.003）。OS 和 CSS 列线图的一致性指数均高于 TNM 分期（分别为 0.772 与 0.730 和 0.807 与 0.768）。根据受试者工作特征曲线下面积，列线图对 1、3 和 5 年生存率的预测能力均优于 TNM 分期。
LNR 是 g-NET 的独立预测因子。本研究绘制的列线图对生存风险具有良好的预测能力，能够为 g-NET 患者制定个体化治疗策略提供指导。
