A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors

NEPscore Working Group

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)607-618
Number of pages12
JournalEndocrine-Related Cancer
Volume25
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

Fingerprint

Neuroendocrine Tumors
Survival
Italy
Calibration
Databases
Neoplasm Metastasis

Keywords

  • Neuroendocrine tumors
  • Overall survival
  • Prognosis
  • Prognostic score
  • Validation

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Oncology
  • Endocrinology
  • Cancer Research

Cite this

A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors. / NEPscore Working Group.

In: Endocrine-Related Cancer, Vol. 25, No. 6, 01.06.2018, p. 607-618.

Research output: Contribution to journalArticle

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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.",
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AU - Pusceddu, Sara

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AU - Botta, Laura

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AU - Mazzaferro, Vincenzo

AU - Pastorino, Ugo

AU - Seregni, Ettore

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AU - Gatta, Gemma

AU - Di Bartolomeo, Maria

AU - Femia, Daniela

AU - Prinzi, Natalie

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AU - Antonuzzo, Lorenzo

AU - Bajetta, Emilio

AU - Pia Brizzi, Maria

AU - Campana, Davide

AU - Catena, Laura

AU - Comber, Harry

AU - Dwane, Fiona

AU - Fazio, Nicola

AU - Faggiano, Antongiulio

AU - Giuffrida, Dario

AU - Henau, Kris

AU - Ibrahim, Toni

AU - Marconcini, Riccardo

AU - Massironi, Sara

AU - Žakelj, Maja Primic

AU - Spada, Francesca

AU - Tafuto, Salvatore

AU - Van Eycken, Elizabeth

AU - Van Der Zwan, Jan Maaten

AU - Žagar, Tina

AU - Giacomelli, Luca

AU - Miceli, Rosalba

AU - Francesca, Aroldi

AU - Alberto, Bongiovanni

AU - Rossana, Berardi

AU - Nicole, Brighi

AU - Sara, Cingarlini

AU - Carolina, Cauchi

AU - Federica, Cavalcoli

AU - Carlo, Carnaghi

AU - Francesca, Corti

AU - Marilina, Duro

AU - Vittoria, Davì Maria

PY - 2018/6/1

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N2 - 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.

AB - 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.

KW - Neuroendocrine tumors

KW - Overall survival

KW - Prognosis

KW - Prognostic score

KW - Validation

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