Colon Neuroendocrine Tumors: A New Lymph Node Staging Classification

Fields, Adam C.; McCarty, Justin C; Lu, Pamela; Vierra, Benjamin M; Pak, Linda M.; Irani, Jennifer; Goldberg, Joel; Bleday, Ronald; Chan, Jennifer A.; Melnitchouk, Nelya

doi:10.1245/s10434-019-07327-6

Cited by 12 publications

(7 citation statements)

References 15 publications

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“…The risk of metastases is verylow (<3%) in rectal NETs< 10 mm and very high (30%-80%) in rectal NETs ≥ 20 mm in size, while betweenthese two extremes, 4%-20% of patients with rectal NETs measuring 10-19 mm have synchronous or metachronous metastases(de Mestier et al 2019). In addition, tumour size and lymph node metastasis have also been shown to be predictors of poor prognosis in colorectal NETs(Fields et al 2019;Sohn et al 2017;Wu et al 2020), consistent with our study.Traditionally, the level of FFA has been detected to assess lipid metabolism and has been associated with hypertension, cardiovascular disease, type 2 diabetes, and obesity(Ghosh et al 2017). Similarly, HDL-C, LDL-C, TG, CHOL, ApoA1) and ApoB, all widely used, were analysed to assesslipid metabolismin the body as combined biochemical indicators.…”

supporting

confidence: 91%

Combined Detection of Free Fatty Acid (FFA) and High-Density Lipoprotein Cholesterol (HDL-C) is a Promising Pretreatment Biomarker for Predicting the Overall Prognosis (OS) of Neuroendocrine Tumours (NETs) in the Colorectum: A Case-Control Study.

Zhu

Yang

et al. 2021

Preprint

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Purpose The aim of the study was to evaluate the prognostic value of free fatty acid (FFA) and high-density lipoprotein cholesterol (HDL-C) in predicting colorectal neuroendocrine tumours (NETs). Methods One hundred patients with pathologically diagnosed colorectal NETs in 2011-2017 were enrolled, and the levels of FFA, HDL-C, low-density lipoproteincholesterol (LDL-C), triglycerides (TGs), cholesterol (CHOL), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) between colorectal NET patients and healthy controls matched by age and sex were compared. In addition, the association of clinicopathological characteristics and follow-up data with FFA and HDL-C was analysed. Results FFA was overexpressed (0.55±0.23 vs. 0.48±0.11, P= 0.006) and HDL-C was underexpressed (1.31±0.41 vs. 1.41±0.29, P=0.046) in colorectal NETs. FFA ≥0.52 mmol/L predicted lymph node metastasis (LNM) (χ2 = 5.964, P=0.015), and HDL-C ≤1.0 mmol/L predicted tumour size ≥2 cm (χ2 = 5.647, P=0.017). No significant association was found between FFA and tumour size (P=0.142) or HDL-C and LNM (P=0.443). FFA ≥0.52 mmol/L (χ2 = 6.016, P=0.014) and HDL-C ≤1.0 mmol/L predicted worse overall survival (OS) (χ2 = 5.488, P=0.019). FFA ≥0.52 mmol/L in combination with HDL-C ≤1.0 mmol/L predicted an even worse prognosis in terms of OS (χ2 = 4.818, P=0.028). Conclusion FFA ≥0.52 mmol/L and HDL-C ≤1.0 mmol/L were promising cut-off values in predicting LNM, tumour size and worse OS in colorectal NETs.

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supporting

confidence: 91%

Combined Detection of Free Fatty Acid (FFA) and High-Density Lipoprotein Cholesterol (HDL-C) is a Promising Pretreatment Biomarker for Predicting the Overall Prognosis (OS) of Neuroendocrine Tumours (NETs) in the Colorectum: A Case-Control Study.

Zhu

Yang

et al. 2021

Preprint

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“…Unlike patients with non-colorectal non-neuroendocrine liver metastases [ 24 – 26 ], surgery, especially in the presence of metastatic disease, may not provide any survival benefit for most patients [ 23 ]. Fields et al [ 27 ] demonstrated that the total number of positive lymph nodes was an independent predictor of survival in patients with colon NENs. Namely, the prognosis differed between patients with no positive lymph nodes, 1 positive lymph node, 2 to 9 positive lymph nodes, and 10 or more positive lymph nodes [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fields et al [ 27 ] demonstrated that the total number of positive lymph nodes was an independent predictor of survival in patients with colon NENs. Namely, the prognosis differed between patients with no positive lymph nodes, 1 positive lymph node, 2 to 9 positive lymph nodes, and 10 or more positive lymph nodes [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of prognostic nomograms for patients with colon neuroendocrine neoplasms

Zhou

et al. 2021

World J Surg Onc

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Background Colon neuroendocrine neoplasms (NENs) have one of the poorest median overall survival (OS) rates among all NENs. The American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) staging system—currently the most commonly used prediction model—has limited prediction accuracy because it does not include parameters such as age, sex, and treatment. The aim of this study was to construct nomograms containing various clinically important parameters to predict the prognosis of patients with colon NENs more accurately. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, we performed a retrospective analysis of colon NENs diagnosed from 1975 to 2016. Data were collected from 1196 patients; almost half were female (617/1196, 51.6%), and the average age was 61.94 ± 13.05 years. Based on the age triple cut-off values, there were 396 (33.1%), 408 (34.1%), and 392 (32.8%) patients in age groups 0–55 years, 55–67 years, and ≥ 68 years, respectively. Patients were randomized into training and validation cohorts (3:1). Independent prognostic factors were used for construction of nomograms to precisely predict OS and cancer-specific survival (CSS) in patients with colon NENs. Results Multivariate analysis showed that age ≥ 68 years, sex, tumor size, grade, chemotherapy, N stage, and M stage were independent predictors of OS. In the validation cohort, the Concordance index (C-index) values of the OS and CSS nomograms were 0.8345 (95% confidence interval [CI], 0.8044–0.8646) and 0.8209 (95% CI, 0.7808–0.861), respectively. C-index also indicated superior performance of both nomograms (C-index 0.8347 for OS and 0.8668 for CSS) compared with the AJCC TNM classification (C-index 0.7159 for OS and 0.7366 for CSS). Conclusions We established and validated new nomograms for more precise prediction of OS and CSS in patients with colon NENs to facilitate individualized clinical decisions.

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“…Surgery, especially in the presence of metastatic disease, may not provide any survival bene t for most patients [21]. Fields et al [22] demonstrated that the total number of positive lymph nodes was an independent predictor of survival in patients with colon NENs. Namely, the prognosis differed between patients with no positive lymph nodes, one positive lymph node, two to nine positive lymph nodes, and 10 or more positive lymph nodes [22].…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Prognostic Nomograms for Patients with Colon Neuroendocrine NeoplasmsPrognostic Nomograms for Colon Nens’ Patients

Zhou

et al. 2021

Preprint

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Background Colon neuroendocrine neoplasms (NENs) have one of the poorest median overall survival (OS) rates among all NENs. The American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) staging system—currently the most commonly used prediction model—has limited prediction accuracy because it does not include parameters such as age, sex, and treatment. The aim of this study was to construct nomograms containing various clinically important parameters to predict the prognosis of patients with colon NENs more accurately. Methods Using the Surveillance, Epidemiology and End Results (SEER) database, we performed a retrospective analysis of colon NENs diagnosed from 1975 to 2016. Data were collected from 1196 patients, most of which were female (617/1196, 51.6%), and the average age was 61.94 ± 13.05 years old. Based on the optimal cutoff value in age (age 0–55 y, 55–67 y, age ≥ 68 y), 396 (33.1%) patients were between 0–55 y, 408 (34.1%) were between 56–67 y and 392 (32.8%) were ≥ 68 y. Patients were randomized into training and validation cohorts (3:1). Independent prognostic factors were used for construction of nomograms to precisely predict OS and cancer-specific survival (CSS) in patients with colon NENs. Results Multivariate analysis showed that age ≥ 68 years, sex, tumor size, grade, chemotherapy, N stage, and M stage were independent predictors of OS. In the validation cohort, the Concordance index (C-index) values of the OS and CSS nomograms were 0.8345 (95% confidence interval [CI], 0.8044–0.8646) and 0.8209 (95% CI, 0.7808–0.861), respectively. C-index also indicated superior performance of both nomograms (C-index 0.8347 for OS and 0.8668 for CSS) compared with the AJCC TNM classification (C-index 0.7159 for OS and 0.7366 for CSS). Conclusions We established and validated new nomograms for more precise prediction of OS and CSS in patients with colon NENs to facilitate individualized clinical decisions.

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Colon Neuroendocrine Tumors: A New Lymph Node Staging Classification

Cited by 12 publications

References 15 publications

Combined Detection of Free Fatty Acid (FFA) and High-Density Lipoprotein Cholesterol (HDL-C) is a Promising Pretreatment Biomarker for Predicting the Overall Prognosis (OS) of Neuroendocrine Tumours (NETs) in the Colorectum: A Case-Control Study.

Combined Detection of Free Fatty Acid (FFA) and High-Density Lipoprotein Cholesterol (HDL-C) is a Promising Pretreatment Biomarker for Predicting the Overall Prognosis (OS) of Neuroendocrine Tumours (NETs) in the Colorectum: A Case-Control Study.

Development and validation of prognostic nomograms for patients with colon neuroendocrine neoplasms

Development and Validation of Prognostic Nomograms for Patients with Colon Neuroendocrine NeoplasmsPrognostic Nomograms for Colon Nens’ Patients

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