Development and validation of a prognostic nomogram to predict recurrence in high-risk gastrointestinal stromal tumour: A retrospective analysis of two independent cohorts

Lin, Yuehui; Wang, Ming; Jia, Jie; Wan, Wenze; Wang, Tao; Yang, Wenchang; Li, Chengguo; Chen, Xin; Cao, Hui; Zhang, Peng; Tao, Kaixiong

doi:10.1016/j.ebiom.2020.103016

Cited by 21 publications

(17 citation statements)

References 20 publications

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“…As reported in previous research[ 24 , 25 ], based on our results, primary tumor size, primary tumor location and the risk grade can affect the surgical procedure. The critical point of tumor size should be further identified using a more effective statistical model[ 26 ]. In addition, primary tumor location should be further subdivided as well as different types of tumor growth (such as exophytic tumor).…”

Section: Discussionmentioning

confidence: 99%

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

et al. 2021

WJGO

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BACKGROUND Duodenal gastrointestinal stromal tumor (DGIST) is a rare tumor with a specific anatomic site and biological characteristics. As the incidence of lymph node metastasis is very low, the main treatment method is surgery. Two main surgical techniques (local resection and Whipple) are performed in patients with DGISTs. The critical question is which surgical technique to choose. AIM To identify factors influencing the choice of surgery for DGISTs. METHODS The clinicopathological data of patients with DGISTs who underwent surgery between January 1999 and January 2021 were analyzed. We used the Student’s t -test or Mann-Whitney U -test and the χ 2 test or Fisher’s exact test to determine the differences between the two groups of patients. Furthermore, we used logistic analysis to identify the relevant factors and independent factors related to the type of surgery. The Kaplan-Meier method was used to analyze the patient’s survival information and Cox regression analysis was performed to determine prognostic risk factors. RESULTS Overall, 86 patients were analyzed, including 43 men (50%) and 43 women (50%). We divided the patients into two groups based on surgical technique (local resection or Whipple surgery). There were no differences in the age, mitotic figures, and complications between the two groups; however, the tumor size, tumor location, risk grade, postoperative hospital stay, and abdominal drainage time were significantly different. Based on univariate logistic analysis, the Whipple procedure was chosen if the tumor size was ≥ 5.0 cm, the tumor was located in the descending part of the duodenum, or the risk grade was medium or high. In our research, the five-year overall survival rate of patients was more than 90%. We also describe two DGIST patients with liver metastases at first diagnosis and analyzed their management in order to provide advice on complicated cases. CONCLUSION The Whipple procedure was performed if the primary tumor was in the descending part of the duodenum, tumor size was ≥ 5.0 cm, or the tumor risk grade was medium or high.

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Section: Discussionmentioning

confidence: 99%

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

et al. 2021

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“…Nomograms, which are statistics-based methods, have been widely applied in prognosis-related clinical studies [12]. In addition, once the clinical variables are incorporated, the nomograms can speci cally calculate the individual survival scores [13].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Survival Nomograms for Patients with Pancreatic Neuroendocrine Tumors: A Population-based Study

Lin

Chen

et al. 2020

Preprint

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Background: Although pancreatic neuroendocrine tumors (PNETs) are considered indolent tumors, most patients are diagnosed at an advanced stage. We aimed to establish a nomogram for clinical use to predict the survival of PNET patients using the Surveillance, Epidemiology, and End Results (SEER) database.Methods: Based on the SEER database, 1,103 patients with PNETs were enrolled and randomly divided into training and validation sets. We performed Kaplan-Meier analysis and Cox proportional hazard regression analysis in the training set to evaluate the value of the prognostic factors. A nomogram was then constructed to analyze these independent prognostic factors for predicting the overall survival (OS) and specific cancer survival (CSS). C-index, calibration curve, and decision curve analysis were used to evaluate the predictive accuracy of the nomogram.Results: Age, primary site, TNM stage, grade, and surgery were associated with OS and CSS in the multivariate models. Nomograms were established depending on these risk factors and had a better discrimination power than the TMN stage. The validation techniques showed that the nomograms were able to predict the 3- and 5-year OS and CSS accurately, and also proved to be superior.Conclusions: Nomograms were established depending on these risk factors and had a better discrimination power than the TMN stage. The validation techniques showed that the nomograms were able to predict 3- and 5-year OS and CSS accurately, and also proved to be superior.

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“…Recently, many studies demonstrated the in uence of peripheral blood hematological indicators of systemic in ammation or nutrition on the long-term prognosis of various cancers and even GISTs after surgical resection [9,[13][14][15][16]]. It's suggested that higher-risk tumors, including GISTs, have a stronger impact on the patients' nutritional state and in ammatory levels.…”

Section: Discussionmentioning

confidence: 99%

“…Predictors from EUS include echogenicity, and the existence of calci cation or liquid area inside the tumor. Besides, previous studies have suggested that some blood in ammatory and nutritious indicators are independent factors in uencing the prognosis of gastrointestinal stromal tumors [9]. Therefore, we also tentatively included them as diagnostic predictors in this study, including peripheral blood leukocytes, neutrophils, lymphocytes, platelets, hemoglobin, alanine transaminase (ALT), glutamic oxaloacetic transaminase (AST), albumin levels, plateletlymphocyte ratio (PLR), neutrophillymphocyte ratio (NLR), systemic immune-in ammation index (SII), De Ritis Ratio (AST/ALT), prognostic nutritional index (PNI), and brinogen level.…”

Section: Predictorsmentioning

confidence: 99%

Development and Validation of a Novel Diagnostic Model for Initially Clinical Diagnosed Gastrointestinal Stromal Tumors Using An Extreme Gradient-Boosting Machine

Wang

Jiang

et al. 2021

Preprint

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INTRODUCTION Gastrointestinal stromal tumor (GIST) is the most common gastrointestinal soft tissue tumor. Clinical diagnosis mainly relies on enhanced CT, endoscopy and endoscopic ultrasound (EUS), but the misdiagnosis rate is still high without fine needle aspiration biopsy. We aim to develop a novel diagnostic model by analyzing the preoperative data of the patients. METHODS We used the data of patients who were initially diagnosed as gastric GIST and underwent partial gastrectomy. The patients were randomly divided into training dataset and test dataset at a ratio of 3 to 1. After pre-experimental screening, max depth = 2, eta = 0.1, gamma = 0.5, and nrounds = 200 were defined as the best parameters, and in this way we developed the initial extreme gradient-boosting (XGBoost) model. Based on the importance of the features in the initial model, we improved the model by excluding the hematological features. In this way we obtained the final XGBoost model and underwent validation using the test dataset. RESULTS In the initial XGBoost model, we found that the hematological indicators (including inflammation and nutritional indicators) examined before the surgery had little effect on the outcome, so we subsequently excluded the hematological indicators. Similarly, we also screened the features from enhanced CT and ultrasound gastroscopy, and finally determined the 6 most important predictors for GIST diagnosis, including the ratio of long and short diameter under CT, the CT value of the tumor, the enhancement of the tumor in arterial period and venous period, existence of liquid area and calcific area inside the tumor under EUS. Round or round-like tumors with a CT value of around 30 (25–37) and delayed enhancement, as well as liquid but not calcific area inside the tumor best indicate the diagnosis of GIST. CONCLUSIONS We developed a model to further differential diagnose GIST from other tumors in initially clinical diagnosed gastric GIST patients by analyzing the results of clinical examinations that most patients should have completed before surgical resection.

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Development and validation of a prognostic nomogram to predict recurrence in high-risk gastrointestinal stromal tumour: A retrospective analysis of two independent cohorts

Cited by 21 publications

References 20 publications

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

WITHDRAWN: Survival Nomograms for Patients with Pancreatic Neuroendocrine Tumors: A Population-based Study

Development and Validation of a Novel Diagnostic Model for Initially Clinical Diagnosed Gastrointestinal Stromal Tumors Using An Extreme Gradient-Boosting Machine

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