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Risk prediction of second primary malignancies in primary colorectal neuroendocrine neoplasms patients: a population-based study

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Abstract

Purpose

In this study, we aimed to identify risk factors for developing second primary malignancies (SPMs) in colorectal neuroendocrine neoplasms (NENs) patients and develop a competing-risk nomogram to predict SPMs’ probabilities quantitatively.

Methods

Patients with colorectal NENs were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database during 2000–2013. Potential risk factors for SPMs’ occurrence in colorectal NENs’ patients were identified by the Fine and Gray’s proportional sub-distribution hazards model. Then, a competing-risk nomogram was constructed to quantify SPMs’ probabilities. The discriminative abilities and calibrations of this competing-risk nomogram were assessed by the area under the receiver-operating characteristic (ROC) curves (AUC) and calibration curves.

Results

We identified 11,017 colorectal NENs’ patients, and randomly divided them into training (n = 7711 patients) and validation (n = 3306 patients) cohorts. In the whole cohort, 12.4% patients (n = 1369) had developed SPMs during the maximum follow-up of approximately 19 years (median 8.9 years). Sex, age, race, primary tumor location, and chemotherapy were identified as risk factors for SPMs’ occurrence in colorectal NENs’ patients. Such factors were selected to develop a competing-risk nomogram and showed excellent predictive ability for SPMs’ occurrence (the 3-, 5-, and 10-year AUC values were 0.631, 0.632, and 0.629 in the training cohort and 0.665, 0.639, 0.624 in the validation cohort, respectively).

Conclusions

This research identified risk factors for SPMs’ occurrence in colorectal NENs’ patients. Competing-risk nomogram was constructed and proved to have good performance.

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Availability of data and materials

All data used in this study can be acquired from the SEER*Stat software (version 8.3.9; https://seer.cancer.gov/seerstat/).

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Acknowledgements

We thank the Surveillance, Epidemiology, and End Results (SEER) Program for generously providing clinical data.

Funding

This work was supported by the Natural Science Foundation Program of China Programs (Grant Nos. 82103457 and 82203584) and the Medical and Health Research Project of Yichang City, China (Grant No. A22-2-058).

Author information

Author notes

  1. X. Ding, X. Yang, and Q. Hao have contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Laboratory, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, People’s Republic of China

    X. Ding, X. Yang & L. Rao

  2. Department of Nursing, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, People’s Republic of China

    Q. Hao

  3. Department of Pharmacy, The People’s Hospital of China Three Gorges University, Yichang, 443000, People’s Republic of China

    F. Xu

  4. College of Basic Medical Science, China Three Gorges University, Yichang, 443002, People’s Republic of China

    X. Yu & C. Yuan

  5. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China

    S. Tian

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Contributions

XD, XY, and QH: investigation, formal analysis, visualization, writing—original draft, and funding acquisition. FX and LR: data curation and validation, XY: methodology, and writing—review and editing. CY and ST: conceptualization, supervision, funding acquisition, and writing—review and editing.

Corresponding authors

Correspondence to C. Yuan or S. Tian.

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Ethical approval

Data used in this study were acquired from a publicly available database. Thus, the approval of the Ethics Committee of Affiliated Renhe Hospital of China Three Gorges University was not required for this study.

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Ding, X., Yang, X., Hao, Q. et al. Risk prediction of second primary malignancies in primary colorectal neuroendocrine neoplasms patients: a population-based study. J Endocrinol Invest 46, 1881–1889 (2023). https://doi.org/10.1007/s40618-023-02047-x

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  • DOI: https://doi.org/10.1007/s40618-023-02047-x

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