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. 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. 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). 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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结肠神经内分泌肿瘤患者预后列线图的开发和验证

在所有 NEN 中，结肠神经内分泌肿瘤 (NEN) 的中位总生存率 (OS) 是最差的之一。美国癌症联合委员会 (AJCC) 肿瘤-淋巴结-转移 (TNM) 分期系统（目前最常用的预测模型）的预测准确性有限，因为它不包括年龄、性别和治疗等参数。本研究的目的是构建包含各种临床重要参数的列线图，以更准确地预测结肠 NEN 患者的预后。使用监测、流行病学和最终结果 (SEER) 数据库，我们对 1975 年至 2016 年诊断出的结肠 NEN 进行了回顾性分析。数据来自 1196 名患者；几乎一半是女性（617/1196，51.6%），平均年龄为 61.94 ± 13.05 岁。基于年龄三重临界值，0-55岁、55-67岁和≥68岁年龄组分别有396（33.1%）、408（34.1%）和392（32.8%）名患者。患者被随机分为训练组和验证组 (3:1)。独立预后因素用于构建列线图，以精确预测结肠 NEN 患者的 OS 和癌症特异性生存率 (CSS)。多变量分析显示年龄≥68岁、性别、肿瘤大小、分级、化疗、N分期和M分期是OS的独立预测因素。在验证队列中，OS 和 CSS 列线图的一致性指数 (C-index) 值分别为 0.8345（95% 置信区间 [CI]，0.8044–0.8646）和 0.8209（95% CI，0.7808–0.861）。C-index 还表明两个列线图的优越性能（OS 的 C-index 0.8347 和 0.8347）。CSS 8668）与 AJCC TNM 分类（OS 的 C 指数 0.7159 和 CSS 的 0.7366）进行比较。我们建立并验证了新的列线图，以更精确地预测结肠 NEN 患者的 OS 和 CSS，以促进个性化的临床决策。