Cargando…
Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms
Purpose: Studies on early recurrence in gastrointestinal neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are lacking and risk factors related to early recurrence are not clear. We evaluated risk factors for early recurrence in such patients and developed a predictive s...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481802/ https://www.ncbi.nlm.nih.gov/pubmed/34604293 http://dx.doi.org/10.3389/fsurg.2021.703138 |
_version_ | 1784576761044926464 |
---|---|
author | Li, Chengguo Zhang, Peng Sun, Xiong Tong, Xin Chen, Xin Li, Chong Yang, Wenchang Liu, Weizhen Wang, Zheng Tao, Kaixiong |
author_facet | Li, Chengguo Zhang, Peng Sun, Xiong Tong, Xin Chen, Xin Li, Chong Yang, Wenchang Liu, Weizhen Wang, Zheng Tao, Kaixiong |
author_sort | Li, Chengguo |
collection | PubMed |
description | Purpose: Studies on early recurrence in gastrointestinal neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are lacking and risk factors related to early recurrence are not clear. We evaluated risk factors for early recurrence in such patients and developed a predictive scoring model. Methods: Patients undergoing curative surgery for GI-NEC or MANEC between January 2010 and January 2019 were included. Early recurrence was defined as recurrence within 12 months after surgery. Risk factors for early recurrence were identified using logistic regression. Results: Of the 80 included patients, 27 developed early recurrence and 53 had no early recurrence. Independent risk factors associated with early recurrence included tumor location in the midgut/hindgut [odds ratio (OR) = 5.077, 95% confidence interval (CI) 1.058–24.352, p = 0.042], alkaline phosphatase (ALP) >80 (OR = 5.331, 95% CI 1.557–18.258, p = 0.008), and lymph node ratio (LNR) >0.25 (OR = 6.578, 95% CI 1.971–21.951, p = 0.002). Risk scores were assigned to tumor location (foregut, 0; midgut/hindgut, 1), ALP (≤80, 0; >80, 1), and LNR (≤0.25, 0; >0.25, 1). Patients with a high risk (score 2–3) for early recurrence had significantly shorter disease-free survival and overall survival than those with low- (score 0) and intermediate risks (score 1) (both p < 0.001). The novel scoring model had superior predictive efficiency for early recurrence over TNM staging (area under the curve 0.795 vs. 0.614, p = 0.003). Conclusion: Tumor location, preoperative ALP, and LNR were independent factors associated with early recurrence after curative surgery for GI-NEC or MANEC. The risk scoring model developed based on these three factors shows superior predictive efficiency. |
format | Online Article Text |
id | pubmed-8481802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84818022021-10-01 Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms Li, Chengguo Zhang, Peng Sun, Xiong Tong, Xin Chen, Xin Li, Chong Yang, Wenchang Liu, Weizhen Wang, Zheng Tao, Kaixiong Front Surg Surgery Purpose: Studies on early recurrence in gastrointestinal neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are lacking and risk factors related to early recurrence are not clear. We evaluated risk factors for early recurrence in such patients and developed a predictive scoring model. Methods: Patients undergoing curative surgery for GI-NEC or MANEC between January 2010 and January 2019 were included. Early recurrence was defined as recurrence within 12 months after surgery. Risk factors for early recurrence were identified using logistic regression. Results: Of the 80 included patients, 27 developed early recurrence and 53 had no early recurrence. Independent risk factors associated with early recurrence included tumor location in the midgut/hindgut [odds ratio (OR) = 5.077, 95% confidence interval (CI) 1.058–24.352, p = 0.042], alkaline phosphatase (ALP) >80 (OR = 5.331, 95% CI 1.557–18.258, p = 0.008), and lymph node ratio (LNR) >0.25 (OR = 6.578, 95% CI 1.971–21.951, p = 0.002). Risk scores were assigned to tumor location (foregut, 0; midgut/hindgut, 1), ALP (≤80, 0; >80, 1), and LNR (≤0.25, 0; >0.25, 1). Patients with a high risk (score 2–3) for early recurrence had significantly shorter disease-free survival and overall survival than those with low- (score 0) and intermediate risks (score 1) (both p < 0.001). The novel scoring model had superior predictive efficiency for early recurrence over TNM staging (area under the curve 0.795 vs. 0.614, p = 0.003). Conclusion: Tumor location, preoperative ALP, and LNR were independent factors associated with early recurrence after curative surgery for GI-NEC or MANEC. The risk scoring model developed based on these three factors shows superior predictive efficiency. Frontiers Media S.A. 2021-09-16 /pmc/articles/PMC8481802/ /pubmed/34604293 http://dx.doi.org/10.3389/fsurg.2021.703138 Text en Copyright © 2021 Li, Zhang, Sun, Tong, Chen, Li, Yang, Liu, Wang and Tao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Li, Chengguo Zhang, Peng Sun, Xiong Tong, Xin Chen, Xin Li, Chong Yang, Wenchang Liu, Weizhen Wang, Zheng Tao, Kaixiong Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title | Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title_full | Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title_fullStr | Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title_full_unstemmed | Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title_short | Risk Factors and Predictive Score Model for Early Recurrence After Curative Surgery in Patients With Poorly Differentiated Gastrointestinal Neuroendocrine Neoplasms |
title_sort | risk factors and predictive score model for early recurrence after curative surgery in patients with poorly differentiated gastrointestinal neuroendocrine neoplasms |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481802/ https://www.ncbi.nlm.nih.gov/pubmed/34604293 http://dx.doi.org/10.3389/fsurg.2021.703138 |
work_keys_str_mv | AT lichengguo riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT zhangpeng riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT sunxiong riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT tongxin riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT chenxin riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT lichong riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT yangwenchang riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT liuweizhen riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT wangzheng riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms AT taokaixiong riskfactorsandpredictivescoremodelforearlyrecurrenceaftercurativesurgeryinpatientswithpoorlydifferentiatedgastrointestinalneuroendocrineneoplasms |