Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, No. 106, Zhongshan Er Road, Guangzhou, P.R. China.
Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
BMC Cancer. 2020 Sep 9;20(1):865. doi: 10.1186/s12885-020-07328-9.
This study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs).
We retrospectively analysed 310 patients with rectal neuroendocrine tumours in 5 hospitals in southern China. All of the patients were assigned to the training set. A multivariable analysis using Cox proportional hazards regression was performed using the training set, and a nomogram was constructed. It was validated on a dataset obtained from the Surveillance, Epidemiology, and End Result (SEER) database of America (n = 547).
In the training set, the nomogram exhibited improved discrimination power compared with the WHO grade guidelines (Herrell's C-index, 0.872 vs 0.794; p < 0.001) and was also better than the seventh AJCC TNM classification (Herrell's C-index, 0.872 vs 0.817; p < 0.001). In the SEER validation dataset, the discrimination was also excellent (C-index, 0.648 vs 0.583, p < 0.001 and 0.648 vs 0.603, p = 0.016, respectively, compared with G grade and TNM classification). Calibration of the nomogram predicted individual survival corresponding closely with the actual survival.
We developed a nomogram predicting 1- and 3-year OS of patients with rectal neuroendocrine tumours. Validation revealed excellent discrimination and calibration, suggesting good clinical utility.
本研究旨在开发一个列线图,以预测直肠神经内分泌肿瘤(NETs)的总生存期(OS)。
我们回顾性分析了中国南方 5 家医院的 310 例直肠神经内分泌肿瘤患者。所有患者均被分配到训练集中。使用 Cox 比例风险回归的多变量分析在训练集中进行,并构建了一个列线图。它在美国的监测、流行病学和最终结果(SEER)数据库中获得的数据集(n=547)上进行了验证。
在训练集中,该列线图与 WHO 分级指南相比显示出改善的判别能力(Herrell 的 C 指数,0.872 比 0.794;p<0.001),并且也优于第七版 AJCC TNM 分类(Herrell 的 C 指数,0.872 比 0.817;p<0.001)。在 SEER 验证数据集,判别能力也非常出色(C 指数,0.648 比 0.583,p<0.001 和 0.648 比 0.603,p=0.016,分别与 G 级和 TNM 分类相比)。列线图的校准预测个体生存与实际生存非常接近。
我们开发了一个预测直肠神经内分泌肿瘤患者 1 年和 3 年 OS 的列线图。验证结果显示出优异的判别和校准能力,表明其具有良好的临床实用性。