No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different European countries, aimed to develop and validate a classification prognostic score for OS in patients with stage IV WDNETs. We retrospectively collected data on 1387 patients: (i) patients treated at the Istituto Nazionale Tumori (Milan, Italy; n = 515); (ii) European cohort of rare NET patients included in the European RARECAREnet database (n = 457); (iii) Italian multicentric cohort of pancreatic NET (pNETs) patients treated at 24 Italian institutions (n = 415). The score was developed using data from patients included in cohort (i) (training set); external validation was performed by applying the score to the data of the two independent cohorts (ii) and (iii) evaluating both calibration and discriminative ability (Harrell C statistic). We used data on age, primary tumor site, metastasis (synchronous vs metachronous), Ki-67, functional status and primary surgery to build the score, which was developed for classifying patients into three groups with differential 10-year OS: (I) favorable risk group: 10-year OS >= 70%; (II) intermediate risk group: 30% <= 10-year OS < 70%; (III) poor risk group: 10-year OS < 30%. The Harrell C statistic was 0.661 in the training set, and 0.626 and 0.601 in the RARECAREnet and Italian multicentric validation sets, respectively. In conclusion, based on the analysis of three 'field-practice' cohorts collected in different settings, we defined and validated a prognostic score to classify patients into three groups with different long-term prognoses.
A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors / Pusceddu, S.; Barretta, F.; Trama, A.; Botta, L.; Milione, M.; Buzzoni, R.; De Braud, F.; Mazzaferro, V.; Pastorino, U.; Seregni, E.; Mariani, L.; Gatta, G.; Di Bartolomeo, M.; Femia, D.; Prinzi, N.; Coppa, J.; Panzuto, F.; Antonuzzo, L.; Bajetta, E.; Pia Brizzi, M.; Campana, D.; Catena, L.; Comber, H.; Dwane, F.; Fazio, N.; Faggiano, A.; Giuffrida, D.; Henau, K.; Ibrahim, T.; Marconcini, R.; Massironi, S.; Zakelj, M. P.; Spada, F.; Tafuto, S.; Van Eycken, E.; Van Der Zwan, J. M.; Zagar, T.; Giacomelli, L.; Miceli, R.. - In: ENDOCRINE-RELATED CANCER. - ISSN 1351-0088. - 25:6(2018), pp. 607-618. [10.1530/ERC-17-0489]
A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors
Massironi S.;
2018-01-01
Abstract
No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different European countries, aimed to develop and validate a classification prognostic score for OS in patients with stage IV WDNETs. We retrospectively collected data on 1387 patients: (i) patients treated at the Istituto Nazionale Tumori (Milan, Italy; n = 515); (ii) European cohort of rare NET patients included in the European RARECAREnet database (n = 457); (iii) Italian multicentric cohort of pancreatic NET (pNETs) patients treated at 24 Italian institutions (n = 415). The score was developed using data from patients included in cohort (i) (training set); external validation was performed by applying the score to the data of the two independent cohorts (ii) and (iii) evaluating both calibration and discriminative ability (Harrell C statistic). We used data on age, primary tumor site, metastasis (synchronous vs metachronous), Ki-67, functional status and primary surgery to build the score, which was developed for classifying patients into three groups with differential 10-year OS: (I) favorable risk group: 10-year OS >= 70%; (II) intermediate risk group: 30% <= 10-year OS < 70%; (III) poor risk group: 10-year OS < 30%. The Harrell C statistic was 0.661 in the training set, and 0.626 and 0.601 in the RARECAREnet and Italian multicentric validation sets, respectively. In conclusion, based on the analysis of three 'field-practice' cohorts collected in different settings, we defined and validated a prognostic score to classify patients into three groups with different long-term prognoses.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
