J Cancer 2019; 10(24):5944-5954. doi:10.7150/jca.35785

Research Paper

A novel and validated nomogram to predict overall survival for gastric neuroendocrine neoplasms

Sheng Zhang, Yi Xin Tong, Xin Hua Zhang, Yu Jie Zhang, Xiang Shang Xu, Ai Tang Xiao, Teng Fei Chao, Jian Ping Gong

Department of Gastrointestinal Surgery Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Jie Fang Ave, No. 1095 Wuhan, China.

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Citation:
Zhang S, Tong YX, Zhang XH, Zhang YJ, Xu XS, Xiao AT, Chao TF, Gong JP. A novel and validated nomogram to predict overall survival for gastric neuroendocrine neoplasms. J Cancer 2019; 10(24):5944-5954. doi:10.7150/jca.35785. Available from http://www.jcancer.org/v10p5944.htm

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Abstract

Background: This study aims to develop and validate an effective nomogram to estimate the individual outcome of patients with Gastric neuroendocrine neoplasms (G-NENs).

Methods: A total of 260 patients diagnosed with G-NENs at two medical centers were included, with 156 patients allocated as training set and 104 patients as validation. Predictive nomogram was constructed based on multivariate analyses using RMS package in R version. The predictive accuracy and discriminative ability were analyzed by C-index, risk group stratification and calibration curve, which was compared with other predictive systems for G-NENs.

Results: In multivariate analysis, age, Ki-67, mitoses, neutrophil to lymphocyte ratio, serum tumor marker and distant metastasis were significantly associated with overall survival. The constructed prognostic nomogram demonstrated a good calibration and discrimination value with 0.884 and 0.852 C-indices in training and validation dataset. Compare to World Health Organization (WHO) grading system (C-indices=0.760 and 0.732) and American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system (C-indices=0.747 and 0.811), the nomogram displayed a better predictive accuracy.

Conclusions: The novel prognostic nomogram showed superior predictive value in overall survival of G-NENs. It might be a useful tool for clinicians in estimating individual survival in G-NENs patients.

Keywords: Gastric neuroendocrine neoplasm, Nomogram, Overall survival