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Development of novel prediction models for nodal and distant metastasis in G1 and G2 colorectal neuroendocrine tumors

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

We aimed to construct novel nomograms for nodal and distant metastasis for patients with G1 and G2 colorectal neuroendocrine tumors (NETs).

Methods

A training set and validation set were obtained by including G1 and G2 colorectal NET patients from the Surveillance, Epidemiology, and End Results database and the Cancer Hospital Chinese Academy of Medical Science, respectively. The area under curve (AUC) values under receiver operating characteristic (ROC) curves, calibration plots, and the Hosmer‒Lemeshow tests were used to evaluate the discriminability and calibration of nomograms.

Results

In total, 3690 and 172 patients were included in the training set and validation set, respectively. Tumor size, location, and T stage were included in the nomogram predicting nodal metastasis. The AUC values of the nomogram were 0.972 (95% confidence interval (CI): 0.964–0.980) and 0.897 (95% CI: 0.846–0.948) in the training set and validation set, respectively. The calibration plots and Hosmer‒Lemeshow test for the training set (P = 0.999) and validation set (P = 0.537) showed good model calibration. Tumor size, T stage, and N stage were incorporated into the nomogram predicting distant metastasis. The ROC curves demonstrated desirable discrimination both in the training set (AUC = 0.938 (95% CI: 0.921–0.954)) and validation set (AUC = 0.938 (95% CI: 0.890–0.988)). The calibration curves and Hosmer‒Lemeshow test indicated acceptable model calibration both in the training set (P = 0.908) and validation set (P = 0.722).

Conclusion

The proposed nomograms may be used as a reliable tool to predict the nodal and distant metastasis in G1 and G2 colorectal NETs.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

References

  1. Kooyker AI, Verbeek WH, van den Berg JG, Tesselaar ME, van Leerdam ME (2020) Change in incidence, characteristics and management of colorectal neuroendocrine tumours in the Netherlands in the last decade. United Eur Gastroenterol J 8:59–67. https://doi.org/10.1177/2050640619865113

    Article  PubMed  Google Scholar 

  2. Hrabe J (2020) Neuroendocrine tumors of the appendix, colon, and rectum. Surg Oncol Clin N Am 29:267–279. https://doi.org/10.1016/j.soc.2019.11.010

    Article  PubMed  Google Scholar 

  3. Abdel-Rahman O (2021) Characterization of a novel entity of G3 (high-grade well-differentiated) colorectal neuroendocrine tumors (NET) in the SEER database. Am J Clin Oncol 44:43. https://doi.org/10.1097/COC.0000000000000777

    Article  CAS  PubMed  Google Scholar 

  4. Caplin M, Sundin A, Nillson O, Baum RP, Klose KJ, Kelestimur F et al (2012) ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology 95:88–97. https://doi.org/10.1159/000335594

    Article  CAS  PubMed  Google Scholar 

  5. Xiao K, Zhao Y, Cai Y, Chen P, Chen J, Ye R et al (2020) The effect of marital status on the survival of patients with colorectal neuroendocrine neoplasms: an analysis of the SEER database. Rev Esp Enferm Dig 112:109–117. https://doi.org/10.17235/reed.2019.6183/2019

  6. Ding X, Tian S, Hu J, Wang G, Yu X, Fu D et al (2021) Risk and prognostic nomograms for colorectal neuroendocrine neoplasm with liver metastasis: a population-based study. Int J Colorectal Dis 36:1915–1927. https://doi.org/10.1007/s00384-021-03920-y

    Article  PubMed  Google Scholar 

  7. Zhu H, Zhao S, Zhang C, Ji K, Wu W, Yin L et al (2021) Endoscopic and surgical treatment of T1N0M0 colorectal neuroendocrine tumors: a population-based comparative study. Surg Endosc. https://doi.org/10.1007/s00464-021-08535-6

    Article  PubMed  PubMed Central  Google Scholar 

  8. Folkert IW, Sinnamon AJ, Concors SJ, Bennett BJ, Fraker DL, Mahmoud NN et al (2020) Grade is a dominant risk factor for metastasis in patients with rectal neuroendocrine tumors. Ann Surg Oncol 27:855–863. https://doi.org/10.1245/s10434-019-07848-0

    Article  PubMed  Google Scholar 

  9. Li YW, He YP, Liu FQ, Peng JJ, Cai SJ, Xu Y et al (2021) Grade G2 rectal neuroendocrine tumor is much more invasive compared with G1 tumor. Front Oncol 11:646536. https://doi.org/10.3389/fonc.2021.646536

  10. Sekiguchi M, Hotta K, Takeuchi Y, Tanaka S, Yamamoto H, Shinmura K et al (2022) Characteristics of colorectal neuroendocrine tumors in patients prospectively enrolled in a Japanese multicenter study: a first report from the C-NET STUDY. J Gastroenterol 57:547–558. https://doi.org/10.1007/s00535-022-01877-5

    Article  PubMed  Google Scholar 

  11. Yamaguchi T, Takahashi K, Yamada K, Bando H, Baba H, Ito M et al (2021) A nationwide, multi-institutional collaborative retrospective study of colorectal neuroendocrine tumors in Japan. Ann Gastroenterol Surg 5:215–220. https://doi.org/10.1002/ags3.12403

    Article  PubMed  Google Scholar 

  12. Yan L, Xu Y, Pan J, Bai J, Long Q, He N et al (2022) Prognostic evaluation of patients with rectal neuroendocrine neoplasms and hepatic metastases: a SEER database analysis. J Oncol 2022:2451282. https://doi.org/10.1155/2022/2451282

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ushigome H, Fukunaga Y, Nagasaki T, Akiyoshi T, Konishi T, Fujimoto Y et al (2019) Difficulty of predicting lymph node metastasis on CT in patients with rectal neuroendocrine tumors. PLoS One 14:e0211675. https://doi.org/10.1371/journal.pone.0211675

  14. Kim BC, Kim YE, Chang HJ, Lee SH, Youk EG, Lee DS et al (2016) Lymph node size is not a reliable criterion for predicting nodal metastasis in rectal neuroendocrine tumours. Colorectal Dis 18:O243-251. https://doi.org/10.1111/codi.13377

    Article  CAS  PubMed  Google Scholar 

  15. Zhou Z, Wang Z, Zhang B, Wu Y, Li G and Wang Z (2021) Comparison of 68Ga-DOTANOC and 18F-FDG PET-CT scans in the evaluation of primary tumors and lymph node metastasis in patients with rectal neuroendocrine tumors. Front Endocrinol (Lausanne) 12:727327. https://doi.org/10.3389/fendo.2021.727327

  16. Chida K, Watanabe J, Hirasawa K, Inayama Y, Misumi T, Kunisaki C et al (2020) A novel risk-scoring system for predicting lymph node metastasis of rectal neuroendocrine tumors. Ann Gastroenterol Surg 4:562–570. https://doi.org/10.1002/ags3.12355

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gamboa AC, Liu Y, Lee RM, Zaidi MY, Staley CA, Russell MC et al (2019) A novel preoperative risk score to predict lymph node positivity for rectal neuroendocrine tumors: An NCDB analysis to guide operative technique. J Surg Oncol 120:932–939. https://doi.org/10.1002/jso.25679

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen Q, Chen J, Deng Y, Zhang Y, Huang Z, Zhao H et al (2022) Nomogram for the prediction of lymph node metastasis and survival outcomes in rectal neuroendocrine tumour patients undergoing resection. J Gastrointest Oncol 13:171–184. https://doi.org/10.21037/jgo-21-573.

  19. Nam SJ, Kim BC, Chang HJ, Jeon HH, Kim J, Kim SY (2022) Risk factors for lymph node metastasis and oncologic outcomes in small rectal neuroendocrine tumors with lymphovascular invasion. Gut Liver 16:228–235. https://doi.org/10.5009/gnl20364

    Article  PubMed  Google Scholar 

  20. Park SB, Kim DJ, Kim HW, Choi CW, Kang DH, Kim SJ et al (2017) Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors? World J Gastroenterol 23:2037–2043. https://doi.org/10.3748/wjg.v23.i11.2037

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chen L, Guo Y, Zhang Y, Liu M, Zhang Y, Lin Y et al (2021) Development of a novel scoring system based on endoscopic appearance for management of rectal neuroendocrine tumors. Endoscopy 53:702–709. https://doi.org/10.1055/a-1274-0161

    Article  PubMed  Google Scholar 

  22. Kunz PL, Reidy-Lagunes D, Anthony LB, Bertino EM, Brendtro K, Chan JA et al (2013) Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas 42:557–577. https://doi.org/10.1097/MPA.0b013e31828e34a4

    Article  PubMed  PubMed Central  Google Scholar 

  23. Anthony LB, Strosberg JR, Klimstra DS, Maples WJ, O’Dorisio TM, Warner RR et al (2010) The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated nets of the distal colon and rectum. Pancreas 39:767–774. https://doi.org/10.1097/MPA.0b013e3181ec1261

    Article  PubMed  Google Scholar 

  24. Clark OH, Benson AB 3rd, Berlin JD, Choti MA, Doherty GM, Engstrom PF et al (2009) NCCN clinical practice guidelines in oncology: neuroendocrine tumors. J Natl Compr Canc Netw 7:712–747. https://doi.org/10.6004/jnccn.2009.0050

    Article  CAS  PubMed  Google Scholar 

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Funding

This study was supported by the following grants: the National Key Research and Development Program (No. 2022YFC2505003) and the Special Fund of China Cancer Research Foundation/Beijing Hope Marathon (No. LC2017L03).

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Authors and Affiliations

  1. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Zhijie Wang & Qian Liu

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  1. Zhijie Wang
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  2. Qian Liu
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Contributions

Wang Zhijie collected and analyzed the data and drafted this manuscript. Qian Liu designed this study and reviewed the manuscript.

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Correspondence to Qian Liu.

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Wang, Z., Liu, Q. Development of novel prediction models for nodal and distant metastasis in G1 and G2 colorectal neuroendocrine tumors. Int J Colorectal Dis 38, 37 (2023). https://doi.org/10.1007/s00384-023-04331-x

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