A Nomogram Based on the Log Odds of Positive Lymph Nodes Predicts the Prognosis of Patients with Colon Neuroendocrine Tumors After Surgery: A Surveillance, Epidemiology, and End Results Population-Based Study

Abstract

Purpose This work focused on determining the highly efficient nodal classification system from American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) classification (eighth edition), positive lymph node, log odds of positive lymph nodes (LODDS), lymph node ratio, examined lymph node, and establishing the new nomogram for predicting cancer-specific survival in colon neuroendocrine tumors (CNETs). Methods From the Surveillance, Epidemiology, and End Results database, 943 CNET cases undergoing radical operation were enrolled, and randomized as training ( n = 663) or validation set ( n = 280). For the above 5 lymph node classification systems, their prediction performances were compared with C-index, Akaike information criterion (AIC), and area under the receiver operating characteristic curve. Univariate together with multivariate regression was carried out for identifying independent risk factors. Afterward, this work established 1 nomogram and confirmed its accuracy based on C-index, calibration curves, together with the area under the curve value. Besides, it was compared with the AJCC TNM classification system with regard to model prediction performance. Results LODSS achieved the greatest area under the curve and C-index, whereas the smallest AIC. Upon multivariate regression, age, histologic grade, T stage, M stage, and LODDS independently predicted the risk of CNETs. For the validation set, the C-index of the nomogram was 0.794, and the area under the curves at 1, 3, and 5 years was 0.826, 0.857, and 0.870, separately. Additionally, as revealed by the C-index, AIC, decision curve analysis, as well as Kaplan–Meier analysis, our nomogram had superior performance to the AJCC TNM classification system. Conclusions For postoperative patients with CNETs, the LODDS might achieve the best prediction performance. Moreover, the LODDS-based nomograms might show superior survival prediction performance to the AJCC TNM classification system (eighth edition).

Log odds of positive lymph nodes (LODDS)-based novel nomogram for survival estimation in patients with invasive micropapillary carcinoma of the breast

“…Several studies have suggested using pLN and pLNR [ 27 , 28 ]. However, the pLN is also directly limited by the eLN, and additional help is needed to avoid staging migration [ 29 – 31 ]. Although the pLNR avoided heterogeneity within the same N status, several limitations still restricted its use: 1) if the pLN was 0, the pLNR was always 0%, regardless of whether the eLN was 10 or 20; and 2) if all the eLNs were positive (i.e., pLN =eLN), the pLNR rate was always 100%, regardless of whether the eLNs were 1 or 10.…”