Rachel score: a nomogram model for predicting the prognosis of lung neuroendocrine tumors

被引:3
作者
La Salvia, A. [1 ,2 ]
Marcozzi, B. [3 ,4 ]
Manai, C. [1 ]
Mazzilli, R. [5 ]
Landi, L. [1 ]
Pallocca, M. [3 ]
Ciliberto, G. [6 ]
Cappuzzo, F. [1 ]
Faggiano, A. [5 ]
机构
[1] IRCCS Regina Elena Natl Canc Inst, Med Oncol 2, Rome, Italy
[2] Natl Inst Hlth ISS, Natl Ctr Drug Res & Evaluat, Rome, Italy
[3] IRCCS Regina Elena Natl Canc Inst, Biostat Bioinformat & Clin Trial Ctr, Rome, Italy
[4] Natl Inst Hlth ISS, Cardiovasc Endocrine Metab Dis & Aging, Rome, Italy
[5] Sapienza Univ Rome, ENETS Ctr Excellence, St Andrea Univ Hosp, Dept Clin & Mol Med, Rome, Italy
[6] IRCCS Regina Elena Natl Canc Inst, Sci Direct, Rome, Italy
关键词
Neuroendocrine tumors; Lung NET; Primary tumor location; Nomogram; Prognostic score; CARCINOID-TUMORS; SURVIVAL; VALIDATION;
D O I
10.1007/s40618-024-02346-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Lung NET, classified in typical carcinoids (TC) and atypical carcinoids (AC), are highly heterogeneous in their biology and prognosis. The histological subtype and TNM stage are well-established prognostic factors for lung NET. In a previous work by our group, we demonstrated a significant impact of laterality on lung NET survival outcomes. Materials and methods We developed a nomogram that integrates relevant prognostic factors to predict lung NET outcomes. By adding the scores for each of the variables included in the model, it was possible to obtain a prognostic score (Rachel score). Wilcoxon non-parametric statistical test was applied among parameters and Harrell's concordance index was used to measure the models' predictive power. To test the discriminatory power and the predictive accuracy of the model, we calculated Gonen and Heller concordance index. Time-dependent ROC curves and their area under the curve (AUC) were used to evaluate the models' predictive performance. Results By applying Rachel score, we were able to identify three prognostic groups (specifically, high, medium and low risk). These three groups were associate to well-defined ranges of points according to the obtained nomogram (I: 0-90, II: 91-130; III: > 130 points), providing a useful tool for prognostic stratification. The overall survival (OS) and progression free survival (PFS) Kaplan-Meier curves confirmed significant differences (p < 0.0001) among the three groups identified by Rachel score. Conclusions A prognostic nomogram was developed, incorporating variables with significant impact on lung NET survival. The nomogram showed a satisfactory and stable ability to predict OS and PFS in this population, confirming the heterogeneity beyond the histopathological diagnosis of TC vs AC.
引用
收藏
页码:2575 / 2586
页数:12
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