Zhuang Yong, Yu Hui, Chen Chang-Jiang, Jian Jin-Liang, Wu Xian-Yi
Department of Gastrointestinal Surgical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Department of Gastrointestinal Surgical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Asian J Surg. 2024 Jan;47(1):433-442. doi: 10.1016/j.asjsur.2023.09.099. Epub 2023 Sep 29.
Colorectal neuroendocrine carcinoma is a relatively rare tumor, for which a prognosis prediction model is lacking. Based on the data from Surveillance, Epidemiology, and End Results (SEER) database and Fujian Cancer Hospital, the study constructed and validated a prognostic nomogram to assess overall survival of patients with colorectal neuroendocrine carcinoma(CRNEC).
We extracted data of patients diagnosed with CRNEC from the SEER database. These patients were randomly divided into a training cohort(N = 1425) and an internal validation cohort(N = 612). Data of patients diagnosed with CRNEC in Fujian Cancer Hospital was collected as an external validation cohort(N = 54). A prognostic nomogram was established. The performance of the nomogram was assessed with ROC curve, C-index and calibration curve. Decision curve analysis(DCA) and ROC curve were used to compare the prediction efficacy of nomogram with the seventh edition of the TNM classification of the American Joint Commission of Cancer.
Nine variables were identified as independent predictors. Nomogram were established by the nine variables. AUC of the nomogram in predicting 1-, 3- and 5-year OS were 0.900, 0.912 and 0.915 in training cohort, 0.900, 0.925 and 0.919 in internal validation cohort, 0.900, 0.903 and 0.928 in external validation cohort. C-index were 0.845, 0.854 and 0.837. Calibration curves overlapped well with reference lines. Compared with the AJCC TNM staging system, the nomogram performed more effectively. Patients classified into low-risk and high-risk groups by the nomogram scores and performed well in stratification.
The prognostic nomogram established and validated in our study can accurately and effectively predict the prognosis of patients with CRNEC.
结直肠神经内分泌癌是一种相对罕见的肿瘤，目前缺乏预后预测模型。基于监测、流行病学和最终结果（SEER）数据库以及福建医科大学附属肿瘤医院的数据，本研究构建并验证了一种预后列线图，以评估结直肠神经内分泌癌（CRNEC）患者的总生存期。
我们从SEER数据库中提取了诊断为CRNEC的患者数据。这些患者被随机分为训练队列（N = 1425）和内部验证队列（N = 612）。收集福建医科大学附属肿瘤医院诊断为CRNEC的患者数据作为外部验证队列（N = 54）。建立了预后列线图。采用ROC曲线、C指数和校准曲线评估列线图的性能。采用决策曲线分析（DCA）和ROC曲线比较列线图与美国癌症联合委员会第七版TNM分类的预测效能。
九个变量被确定为独立预测因素。由这九个变量建立列线图。列线图预测训练队列1年、3年和5年总生存期的AUC分别为0.900、0.912和0.915，内部验证队列分别为0.900、0.925和0.919，外部验证队列分别为0.900、0.903和0.928。C指数分别为0.845、0.854和0.837。校准曲线与参考线拟合良好。与AJCC TNM分期系统相比，列线图表现更有效。根据列线图评分将患者分为低风险和高风险组，分层效果良好。
我们的研究中建立并验证的预后列线图能够准确有效地预测CRNEC患者的预后。
