The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis
Aim: The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS)...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2019-02-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/8/3/EC-18-0485.xml |
| _version_ | 1818203620777132032 |
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| author | Chao-bin He Yu Zhang Zhi-yuan Cai Xiao-jun Lin |
| author_facet | Chao-bin He Yu Zhang Zhi-yuan Cai Xiao-jun Lin |
| author_sort | Chao-bin He |
| collection | DOAJ |
| description | Aim: The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS) and cancer-specific survival (CSS) based on a large population-based cohort.
Methods: Patients diagnosed with metastatic PNETs between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively collected. Nomograms for estimating OS and CSS were established based on Cox regression model and Fine and Grey’s model. The precision of the nomograms was evaluated and compared using concordance index (C-index) and the area under receiver operating characteristic (ROC) curve (AUC).
Results: The study cohort included 1966 patients with metastatic PNETs. It was shown that the surgery provided survival benefit for all groups of patients with metastatic PNETs. In the whole study cohort, 1-, 2- and 3-year OS and CSS were 51.5, 37.1 and 29.4% and 53.0, 38.9 and 31.1%, respectively. The established nomograms were well calibrated, and had good discriminative ability, with C-indexes of 0.773 for OS prediction and 0.774 for CSS prediction.
Conclusions: Patients with metastatic PNETs could benefit from surgery when the surgery tolerance was acceptable. The established nomograms could stratify patients who were categorized as tumor-node-metastasis (TNM) IV stage into groups with diverse prognoses, showing better discrimination and calibration of the established nomograms, compared with 8th TNM stage system in predicting OS and CSS for patients with metastatic PNETs. |
| first_indexed | 2024-12-12T03:28:15Z |
| format | Article |
| id | doaj.art-ed2aba25b2ad480596ae7b262685f06c |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-12-12T03:28:15Z |
| publishDate | 2019-02-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-ed2aba25b2ad480596ae7b262685f06c2022-12-22T00:39:58ZengBioscientificaEndocrine Connections2049-36142049-36142019-02-0183239251https://doi.org/10.1530/EC-18-0485The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysisChao-bin He0Yu Zhang1Zhi-yuan Cai2Xiao-jun Lin3Department of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of ChinaDepartment of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of ChinaDepartment of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of ChinaAim: The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS) and cancer-specific survival (CSS) based on a large population-based cohort. Methods: Patients diagnosed with metastatic PNETs between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively collected. Nomograms for estimating OS and CSS were established based on Cox regression model and Fine and Grey’s model. The precision of the nomograms was evaluated and compared using concordance index (C-index) and the area under receiver operating characteristic (ROC) curve (AUC). Results: The study cohort included 1966 patients with metastatic PNETs. It was shown that the surgery provided survival benefit for all groups of patients with metastatic PNETs. In the whole study cohort, 1-, 2- and 3-year OS and CSS were 51.5, 37.1 and 29.4% and 53.0, 38.9 and 31.1%, respectively. The established nomograms were well calibrated, and had good discriminative ability, with C-indexes of 0.773 for OS prediction and 0.774 for CSS prediction. Conclusions: Patients with metastatic PNETs could benefit from surgery when the surgery tolerance was acceptable. The established nomograms could stratify patients who were categorized as tumor-node-metastasis (TNM) IV stage into groups with diverse prognoses, showing better discrimination and calibration of the established nomograms, compared with 8th TNM stage system in predicting OS and CSS for patients with metastatic PNETs.https://ec.bioscientifica.com/view/journals/ec/8/3/EC-18-0485.xmlpancreatic neuroendocrine tumormetastasissurgerycompeting risk analysis |
| spellingShingle | Chao-bin He Yu Zhang Zhi-yuan Cai Xiao-jun Lin The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis Endocrine Connections pancreatic neuroendocrine tumor metastasis surgery competing risk analysis |
| title | The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis |
| title_full | The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis |
| title_fullStr | The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis |
| title_full_unstemmed | The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis |
| title_short | The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis |
| title_sort | impact of surgery in metastatic pancreatic neuroendocrine tumors a competing risk analysis |
| topic | pancreatic neuroendocrine tumor metastasis surgery competing risk analysis |
| url | https://ec.bioscientifica.com/view/journals/ec/8/3/EC-18-0485.xml |
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