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

S. Pusceddu, F. Barretta, A. Trama, L. Botta, M. Milione, R. Buzzoni, F. De Braud, V. Mazzaferro, U. Pastorino, E. Seregni, L. Mariani, G. Gatta, M. Di Bartolomeo, D. Femia, N. Prinzi, J. Coppa, F. Panzuto, L. Antonuzzo, E. Bajetta, M. Pia BrizziD. Campana, L. Catena, H. Comber, F. Dwane, N. Fazio, A. Faggiano, D. Giuffrida, K. Henau, T. Ibrahim, R. Marconcini, S. Massironi, M.P. Žakelj, F. Spada, S. Tafuto, E. Van Eycken, J.M. Van Der Zwan, T. Žagar, L. Giacomelli, R. Miceli, A. Francesca, B. Alberto, B. Rossana, B. Nicole, C. Sara, C. Carolina, C. Federica, C. Carlo, C. Francesca, D. Marilina, D.M. Vittoria, D.D. Chiara, E. Paola, L.S. Anna, L. Gabriele, L.R. Giuseppe, N. Federico, R. Alessandra, P. Vittorio, R. Paola, R. Maria, S. Sabine, T. Martina, V.D. Boukje, V. Otto, V. Claudio, NEPscore Working Group

Research output: Contribution to journalArticlepeer-review


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


  • Neuroendocrine tumors
  • Overall survival
  • Prognosis
  • Prognostic score
  • Validation
  • antineoplastic agent
  • Ki 67 antigen
  • peptide receptor radionuclide
  • unclassified drug
  • adult
  • aged
  • Article
  • cancer classification
  • cancer prognosis
  • cancer staging
  • cohort analysis
  • female
  • functional status
  • gastroenteropancreatic neuroendocrine tumor
  • human
  • lung cancer
  • major clinical study
  • male
  • medical record review
  • metastasis
  • middle aged
  • neuroendocrine tumor
  • overall survival
  • pancreas islet cell tumor
  • primary tumor
  • progression free survival
  • retrospective study


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