Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Curr Oncol. 2023 Feb 28;30(3):2889-2899. doi: 10.3390/curroncol30030221.
Neuroendocrine neoplasms of the gallbladder (GB-NENs) are a rare group of histologically heterogeneous tumors, and surgical resection of the primary tumor is the mainstream treatment at the moment. The current study aimed to establish and validate novel nomograms for patients with GB-NENs undergoing primary tumor resection to predict the 6-, 12-, and 18-month overall survival (OS) and cancer-specific survival (CSS).
Clinicopathological information of patients with GB-NENs undergoing primary tumor resection between 2004 and 2018 was derived from the Surveillance, Epidemiology, and End Results (SEER) database. Candidate prognostic factors were selected by Cox regression analyses, and the nomograms were constructed. Finally, concordance index (C-index), calibration plot, area under the curve from the receiver operating characteristic curve (AUC), and decision curve analysis (DCA) were utilized to assess the effective performance of the nomograms.
A total of 221 patients with GB-NENs undergoing resection were enrolled in this retrospective study. Using the Cox regression analyses, age, pathological classification, tumor size, and SEER stage were identified as the independent prognostic factors of patients with GB-NENs undergoing resection, and nomograms were constructed. The C-indexes of OS and CSS in training dataset were 0.802 (95% CI: 0.757-0.848) and 0.846 (95% CI: 0.798-0.895), while those of internal validation dataset were 0.862 (95% CI: 0.802-0.922) and 0.879 (95% CI: 0.824-0.934), respectively.
Taken together, the nomograms are accurate enough to predict the prognostic factors of GB-NEN patients undergoing resection, allowing for treatment decision-making and clinical monitoring for future clinical work.
胆囊神经内分泌肿瘤（GB-NENs）是一组组织学异质性的罕见肿瘤，目前主流的治疗方法是手术切除原发肿瘤。本研究旨在建立和验证用于接受原发肿瘤切除术的 GB-NEN 患者的新列线图，以预测患者 6、12 和 18 个月的总生存（OS）和癌症特异性生存（CSS）。
从监测、流行病学和最终结果（SEER）数据库中提取 2004 年至 2018 年期间接受原发肿瘤切除术的 GB-NEN 患者的临床病理信息。通过 Cox 回归分析选择候选预后因素，并构建列线图。最后，利用一致性指数（C-index）、校准图、接收者操作特征曲线下面积（AUC）和决策曲线分析（DCA）评估列线图的有效性能。
本回顾性研究共纳入 221 例接受切除术的 GB-NEN 患者。通过 Cox 回归分析，年龄、病理分级、肿瘤大小和 SEER 分期被确定为接受切除术的 GB-NEN 患者的独立预后因素，并构建了列线图。训练数据集的 OS 和 CSS 的 C-index 分别为 0.802（95%CI：0.757-0.848）和 0.846（95%CI：0.798-0.895），内部验证数据集的 C-index 分别为 0.862（95%CI：0.802-0.922）和 0.879（95%CI：0.824-0.934）。
总之，这些列线图足以准确预测接受切除术的 GB-NEN 患者的预后因素，为未来的临床工作提供了治疗决策和临床监测的依据。
