Using a Nomogram to Predict Overall Survival in Patients With GEP-NETs

Around the world, the number of patients diagnosed with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) has risen over the past few decades. Despite an increased number of cases, patient prognosis has remained challenging to determine due to a lack of consistent treatment options.

A recent study from Dr. Zenghong Wu and colleagues sought to compare the benefits of a nomogram with the 7th American Joint Committee on Cancer (AJCC) staging system in predicting overall survival (OS) for patients with GEP-NETs.

Researchers analyzed the data of 42,665 patients with GEP-NETs who were diagnosed between 2004 and 2015. After removing patients who did not have the appropriate clinicopathologic characteristics, investigators categorized the remaining 7564 patients into training (n=3782) and testing (n=3782) cohorts.

Following univariate analysis, Dr. Wu and colleagues found that sex, age, race, tumor location, pathology type, stage, surgery, radiation, chemotherapy, tumor size, and Surveillance, Epidemiology, and End Results Program historic stage were strongly connected to OS.

The concordance index (C-index) of the nomogram that predicted OS in the training set was 0.816 for internal validation and 0.822 for external validation.

Investigators noted that the nomogram resulted in minimum Akaike information criterion values and C-index of OS in both the training and testing cohorts when compared with the AJCC staging system. According to decision curve analysis, the nomogram proved more effective than the AJCC staging system because the model resulted in more clinical benefits within a wider threshold probability range.

The researchers concluded that the nomogram was better able to predict OS in patients with GEP-NETs than the AJCC staging system.

“We highly recommend using our nomogram to evaluate individual risks based on different clinical features of GEP-NETs, which can improve the diagnosis and treatment outcomes of GEP-NETs patients and improve their quality of life,” the researchers wrote.