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Author Notes:

Address all correspondence to: Timothy M. Pawlik, MD, MPH, PhD, FACS, Professor and Chair Department of Surgery, The Urban Meyer III and Shelley Meyer Chair in Cancer Research, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH 43210, USA.

Merath and Bagante equally contributed to this manuscript.

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Surgery
  • neuroendocrine tumors
  • nomogram
  • recurrence
  • LYMPH-NODE METASTASIS
  • RELAPSE-FREE SURVIVAL
  • CONSENSUS-GUIDELINES
  • PROGNOSTIC-FACTORS
  • ENDOCRINE TUMORS
  • SINGLE INSTITUTION
  • LIVER METASTASES
  • GRADING SYSTEM
  • MANAGEMENT
  • NEOPLASMS

Nomogram predicting the risk of recurrence after curative-intent resection of primary non-metastatic gastrointestinal neuroendocrine tumors: An analysis of the US Neuroendocrine Tumor Study Group

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Journal Title:

Journal of Surgical Oncology

Volume:

Volume 117, Number 5

Publisher:

, Pages 868-878

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: The risk of recurrence after resection of non-metastatic gastro-entero-pancreatic neuroendocrine tumors (GEP-NET) is poorly defined. We developed/validated a nomogram to predict risk of recurrence after curative-intent resection. Methods: A training set to develop the nomogram and test set for validation were identified. The predictive ability of the nomogram was assessed using c-indices. Results: Among 1477 patients, 673 (46%) were included in the training set and 804 (54%) in y the test set. On multivariable analysis, Ki-67, tumor size, nodal status, and invasion of adjacent organs were independent predictors of DFS. The risk of death increased by 8% for each percentage increase in the Ki-67 index (HR 1.08, 95% CI, 1.05-1.10; P < 0.001). GEP-NET invading adjacent organs had a HR of 1.65 (95% CI, 1.03-2.65; P = 0.038), similar to tumors ≥3 cm (HR 1.67, 95% CI, 1.11-2.51; P = 0.014). Patients with 1-3 positive nodes and patients with >3 positive nodes had a HR of 1.81 (95% CI, 1.12-2.87; P = 0.014) and 2.51 (95% CI, 1.50-4.24; P < 0.001), respectively. The nomogram demonstrated good ability to predict risk of recurrence (c-index: training set, 0.739; test set, 0.718). Conclusion: The nomogram was able to predict the risk of recurrence and can be easily applied in the clinical setting.

Copyright information:

© 2018 Wiley Periodicals, Inc.

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