Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (3): 218-224.doi: 10.24920/003722
• Original Article • Previous Articles Next Articles
Using a Nomogram to Preoperatively Predict Distant Metastasis of Pancreatic Neuroendocrine Tumor in Elderly Patients
Gang Li, Yuntao Bing, Maolin Tian, Chunhui Yuan(
), Dianrong Xiu()
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
-
Received:2020-02-20Accepted:2020-05-10Published:2021-09-30Online:2021-08-30 -
Contact:Chunhui Yuan,Dianrong Xiu E-mail:ychdoctor@163.com;xiudianrong1964@163.com
Cite this article
Gang Li, Yuntao Bing, Maolin Tian, Chunhui Yuan, Dianrong Xiu. Using a Nomogram to Preoperatively Predict Distant Metastasis of Pancreatic Neuroendocrine Tumor in Elderly Patients[J].Chinese Medical Sciences Journal, 2021, 36(3): 218-224.
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Figure 1.
The flow chart of patient selection and screening from the SEER database"
Figure 1.
Table 1
Demographic, clinical and staging characteristics of training cohort and validation cohort [n(%)]"
| Characteristics | Training cohort (n=260) | Validation cohort (n=151) |
|---|---|---|
| Age at diagnosis of pNETs (yrs) | ||
| 65-74 | 162 (62.3) | 108 (71.5) |
| ≥75 | 98 (37.7) | 43 (28.5) |
| Sex | ||
| Male | 147 (56.5) | 84 (55.6) |
| Female | 113 (43.5) | 67 (44.4) |
| Race | ||
| White | 211 (81.2) | 130 (86.1) |
| African American | 17 (6.5) | 16 (10.6) |
| Others* | 32 (12.3) | 5 (3.3) |
| Year of diagnosis | ||
| 2004-2009 | 90 (34.6) | 24 (15.9) |
| 2010-2014 | 170 (65.4) | 127 (84.1) |
| Tumor site | ||
| Head of pancreas | 98 (37.7) | 65 (43.0) |
| Body or tail of pancreas | 141 (54.2) | 75 (49.7) |
| Overlap# | 21 (8.1) | 11 (7.3) |
| Histological grade | ||
| Well/moderate differentiated | 201 (77.3) | 117 (77.5) |
| Poor/undifferentiated | 59 (22.7) | 34 (22.5) |
| T stage (6th edition) | ||
| T1 | 46 (17.7) | 33 (21.9) |
| T2 | 100 (38.5) | 61 (40.4) |
| T3 | 99 (38.1) | 43 (28.5) |
| T4 | 15 (5.8) | 14 (9.3) |
| N stage (6th edition) | ||
| N0 | 174 (66.9) | 101 (66.9) |
| N1 | 86 (33.1) | 50 (33.1) |
| M stage | ||
| M0 | 158 (60.8) | 91 (60.3) |
| M1 | 102 (39.2) | 60 (39.7) |
| Marital status | ||
| Unmarried‡ | 93 (35.8) | 44 (29.1) |
| Married | 167 (64.2) | 107 (70.9) |
Table 1
Table 2
Logistic analyses on metastasis of elderly pNETs patients with the training cohort"
| Variables* | Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|---|
| OR (95% CI) | P | OR (95% CI) | P | ||
| Age at diagnosis (y/d) | |||||
| 65-74 | Reference | ||||
| ≥75 | 1.112 (0.666-1.857) | 0.684 | |||
| Sex | |||||
| Male | Reference | ||||
| Female | 0.916 (0.554-1.515) | 0.733 | |||
| Race | |||||
| White | Reference | ||||
| The African American | 1.701 (0.631-4.584) | 0.294 | |||
| Others | 0.592 (0.261-1.341) | 0.209 | |||
| Marital status | |||||
| Unmarried | Reference | ||||
| Married | 0.899 (0.536-1.510) | 0.688 | |||
| Year of diagnosis | |||||
| 2004-2009 | Reference | ||||
| 2010-2014 | 0.826 (0.491-1.391) | 0.472 | |||
| Site of the tumor | |||||
| Head of pancreas | Reference | Reference | |||
| Body / tail of pancreas | 1.084 (0.635-1.852) | 0.768 | 2.282 (1.174-4.436) | 0.015 | |
| Overlap | 3.600 (1.328-9.756) | 0.012 | 4.659 (1.471-14.760) | 0.009 | |
| Histological grade | |||||
| Well / moderate differentiated | Reference | Reference | |||
| Poor / undifferentiated | 3.202 (1.756-5.836) | 0.000 | 2.600 (1.266-5.339) | 0.009 | |
| T stage | |||||
| T1 | Reference | Reference | |||
| T2 | 11.85 (2.709-51.80) | 0.001 | 8.913 (1.985-40.010) | 0.004 | |
| T3 | 24.34 (5.591-106.0) | 0.000 | 11.830 (2.530-55.350) | 0.002 | |
| T4 | 143.0 (18.310-1117) | 0.000 | 68.650 (8.020-587.600) | 0.000 | |
| N stage | |||||
| N0 | Reference | Reference | |||
| N1 | 5.194 (2.976-9.065) | 0.000 | 3.480 (1.807-6.703) | 0.000 | |
Table 2
Figure 2.
Nomogram for predicting risk of distant metastasis in elderly pNETs patients (≥65 years old)"
Figure 2.
Figure 3.
The calibration curves for predicting distant metastasis in elderly pNETs patients by the established nomogram (A) Of the training cohort (internal calibration). (B) Of the validation cohort (external calibration). The “Apparent” and “Bias-corrected” lines represent perfect agreement between the predicted probabilities (x-axis) and the actual probabilities (y-axis). A perfectly accurate nomogram prediction model would result in a plot where the actual and predicted probabilities fall along the 45° line."
Figure 3.
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