A nomogram model based on neuroendocrine markers for predicting the prognosis of neuroendocrine carcinoma of cervix

Abstract

Purpose Combining traditional clinical parameters with neuroendocrine markers to construct a nomogram model to predict the postoperative recurrence of neuroendocrine carcinoma of cervix (NECC). Methods 257 patients were included in this study, of which, 171 patients diagnosed with NECC who underwent surgery at West China Second Hospital of Sichuan University were considered as part of the training cohort. The univariate and multivariate Cox regression analyses were used in screening the high-risk factors related to cancer recurrence in the training cohort to establish a nomogram model which was further independently validated in the remaining 86 patients who underwent surgery at First Affiliated Hospital of Chongqing Medical University. The calibration curve was used to conduct the internal and external verification of the model. Results Overall, 41 relapse cases were observed in the training (23 cases) and validation (18 cases) cohorts. The univariate analysis preliminarily showed that FIGO stage, stromal invasion, nerve invasion, lymph vascular space invasion, lymph node involvement, cervical-uterine junction invasion and CgA were correlated with NECC recurrence. The multivariate analysis further confirmed that FIGO stage (P = 0.023), stromal invasion (P = 0.002), lymph vascular space invasion (P = 0.039) and lymph node involvement (P = 0.00) were independent risk factors for NECC recurrence, which were ultimately included in the nomogram model. In addition, superior consistency indices were demonstrated in the training (0.863, 95%CI 0.784–0.942) and validation (0.884, 95%CI 0.758–1.010) cohorts. Conclusion The established nomogram model combining traditional clinical parameters with neuroendocrine markers can reliably and accurately predict the recurrence risks in NECC patients.