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Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Carcinoid Tumor | Research article

Prognostic nomogram for predicting long-term cancer-specific survival in patients with lung carcinoid tumors

Authors: Yanqi He, Feng Zhao, Qingbing Han, Yiwu Zhou, Shuang Zhao

Published in: BMC Cancer | Issue 1/2021

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Abstract

Background

Lung carcinoid is a rare malignant tumor with poor survival. The current study established a nomogram model for predicting cancer-specific survival (CSS) in patients with lung carcinoid tumors.

Methods

A total of 1956 patients diagnosed with primary lung carcinoid tumors were extracted from the Surveillance, Epidemiology, and End Results database. The specific predictors of CSS for lung carcinoid tumors were identified and integrated to build a nomogram. Validation of the nomogram was conducted using parameters concordance index (C-index), calibration plots, decision curve analyses (DCAs), and the receiver operating characteristic (ROC) curve.

Results

Age at diagnosis, grade, histological type, N stage, M stage, surgery of the primary site, radiation of the primary site, and tumor size were independent prognostic factors of CSS. High discriminative accuracy of the nomogram model was shown in the training cohort (C-index = 0.873), which was also testified in the internal validation cohort (C-index = 0.861). In both cohorts, the calibration plots showed good concordance between the predicted and observed CSS at 3, 5, and 10 years. The DCA showed great potential for clinical application. The ROC curve showed superior survival predictive ability of the nomogram model (area under the curve = 0.868).

Conclusions

We developed a practical nomogram that provided independent predictions of CSS for patients with lung carcinoid tumors. This nomogram may have the potential to assist clinicians in prognostic evaluations or developing individualized therapies for patients with this neoplasm.
Literature
1.
go back to reference Naalsund A, Rostad H, Strom EH, Lund MB, Strand TE. Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. Eur J Cardiothorac Surg. 2011;39(4):565–9.CrossRef Naalsund A, Rostad H, Strom EH, Lund MB, Strand TE. Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. Eur J Cardiothorac Surg. 2011;39(4):565–9.CrossRef
2.
go back to reference Morandi U, Casali C, Rossi G. Bronchial typical carcinoid tumors. Semin Thorac Cardiovasc Surg. 2006;18(3):191–8.CrossRef Morandi U, Casali C, Rossi G. Bronchial typical carcinoid tumors. Semin Thorac Cardiovasc Surg. 2006;18(3):191–8.CrossRef
3.
go back to reference Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97(4):934–59.CrossRef Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97(4):934–59.CrossRef
4.
go back to reference Micke P, Mattsson JS, Djureinovic D, et al. The impact of the fourth edition of the WHO classification of lung tumours on histological classification of resected pulmonary NSCCs. J Thorac Oncol. 2016;11(6):862–72.CrossRef Micke P, Mattsson JS, Djureinovic D, et al. The impact of the fourth edition of the WHO classification of lung tumours on histological classification of resected pulmonary NSCCs. J Thorac Oncol. 2016;11(6):862–72.CrossRef
5.
go back to reference Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung Tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10(9):1243–60.CrossRef Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung Tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10(9):1243–60.CrossRef
6.
go back to reference Thomas CF, Tazelaar HD, Jett JR. Typical and atypical pulmonary carcinoids - outcome in patients presenting with regional lymph node involvement. Chest. 2001;119(4):1143–50.CrossRef Thomas CF, Tazelaar HD, Jett JR. Typical and atypical pulmonary carcinoids - outcome in patients presenting with regional lymph node involvement. Chest. 2001;119(4):1143–50.CrossRef
7.
go back to reference Cardillo G, Sera F, Di Martino M, et al. Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg. 2004;77(5):1781–5.CrossRef Cardillo G, Sera F, Di Martino M, et al. Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg. 2004;77(5):1781–5.CrossRef
8.
go back to reference Maurizi G, Ibrahim M, Andreetti C, et al. Long-term results after resection of bronchial carcinoid tumour: evaluation of survival and prognostic factors. Interact Cardiov Th. 2014;19(2):239–44.CrossRef Maurizi G, Ibrahim M, Andreetti C, et al. Long-term results after resection of bronchial carcinoid tumour: evaluation of survival and prognostic factors. Interact Cardiov Th. 2014;19(2):239–44.CrossRef
9.
go back to reference Chaudhuri N, Singh R, Seraman S, et al. Bronchial carcinoid tumours: surgical management and long term outcome. Thorax. 2004;59(1):36. Chaudhuri N, Singh R, Seraman S, et al. Bronchial carcinoid tumours: surgical management and long term outcome. Thorax. 2004;59(1):36.
10.
go back to reference Garcia-Yuste M, Matilla JM, Cueto A, et al. Typical and atypical carcinoid tumours: analysis of the experience of the Spanish multi-centric study of neuroendocrine tumours of the lung. Eur J Cardio-Thorac. 2007;31(2):192–7.CrossRef Garcia-Yuste M, Matilla JM, Cueto A, et al. Typical and atypical carcinoid tumours: analysis of the experience of the Spanish multi-centric study of neuroendocrine tumours of the lung. Eur J Cardio-Thorac. 2007;31(2):192–7.CrossRef
11.
go back to reference Kneuertz PJ, Kamel MK, Stiles BM, et al. Incidence and prognostic significance of carcinoid lymph node metastases. Ann Thorac Surg. 2018;106(4):981–8.CrossRef Kneuertz PJ, Kamel MK, Stiles BM, et al. Incidence and prognostic significance of carcinoid lymph node metastases. Ann Thorac Surg. 2018;106(4):981–8.CrossRef
12.
go back to reference Phan AT, Oberg K, Choi J, et al. NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus). Pancreas. 2010;39(6):784–98.CrossRef Phan AT, Oberg K, Choi J, et al. NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus). Pancreas. 2010;39(6):784–98.CrossRef
13.
go back to reference Caplin ME, Baudin E, Ferolla P, et al. Pulmonary neuroendocrine (carcinoid) tumors: European neuroendocrine tumor society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26(8):1604–20.CrossRef Caplin ME, Baudin E, Ferolla P, et al. Pulmonary neuroendocrine (carcinoid) tumors: European neuroendocrine tumor society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26(8):1604–20.CrossRef
14.
go back to reference Steuer CE, Behera M, Kim S, et al. Clinical characteristics and outcomes of atypical carcinoid (AC) tumor of the lung: A Surveillance, Epidemiology, and End Results database analysis, J Clin Oncol. 2014;32:15. Steuer CE, Behera M, Kim S, et al. Clinical characteristics and outcomes of atypical carcinoid (AC) tumor of the lung: A Surveillance, Epidemiology, and End Results database analysis, J Clin Oncol. 2014;32:15.
15.
go back to reference Yan T, Wang K, Liu JC, et al. Wedge resection is equal to segmental resection for pulmonary typical carcinoid patients at localized stage: a population-based analysis. Peerj. 2019:7. Yan T, Wang K, Liu JC, et al. Wedge resection is equal to segmental resection for pulmonary typical carcinoid patients at localized stage: a population-based analysis. Peerj. 2019:7.
16.
go back to reference Raz DJ, Nelson RA, Grannis FW, Kim JY. Natural history of typical pulmonary carcinoid Tumors a comparison of nonsurgical and surgical treatment. Chest. 2015;147(4):1111–7.CrossRef Raz DJ, Nelson RA, Grannis FW, Kim JY. Natural history of typical pulmonary carcinoid Tumors a comparison of nonsurgical and surgical treatment. Chest. 2015;147(4):1111–7.CrossRef
17.
go back to reference Iasonos A, Schrag D, Raj GV, Panageas KS. How to build and interpret a nomogram for cancer prognosis. J Clin Oncol. 2008;26(8):1364–70.CrossRef Iasonos A, Schrag D, Raj GV, Panageas KS. How to build and interpret a nomogram for cancer prognosis. J Clin Oncol. 2008;26(8):1364–70.CrossRef
18.
go back to reference Balachandran VP, Gonen M, Smith JJ, DeMatteo RP. Nomograms in oncology: more than meets the eye. Lancet Oncol. 2015;16(4):E173–80.CrossRef Balachandran VP, Gonen M, Smith JJ, DeMatteo RP. Nomograms in oncology: more than meets the eye. Lancet Oncol. 2015;16(4):E173–80.CrossRef
19.
go back to reference Young KA, Efiong E, Dove JT, et al. External validation of a survival Nomogram for non-small cell lung Cancer using the National Cancer Database. Ann Surg Oncol. 2017;24(6):1459–64.CrossRef Young KA, Efiong E, Dove JT, et al. External validation of a survival Nomogram for non-small cell lung Cancer using the National Cancer Database. Ann Surg Oncol. 2017;24(6):1459–64.CrossRef
20.
go back to reference Zheng ZF, Lu J, Wang W, et al. Development and external validation of a simplified Nomogram predicting individual survival after R0 resection for gastric Cancer: an international, Multicenter Study. Ann Surg Oncol. 2018;25(8):2383–90.CrossRef Zheng ZF, Lu J, Wang W, et al. Development and external validation of a simplified Nomogram predicting individual survival after R0 resection for gastric Cancer: an international, Multicenter Study. Ann Surg Oncol. 2018;25(8):2383–90.CrossRef
21.
go back to reference Howlader N NA, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2016, National Cancer institute. Bethesda. https://seer.cancer.gov/csr/1975_2016/, based on November 2018 SEER data submission, posted to the SEER web site, April 2019. Howlader N NA, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2016, National Cancer institute. Bethesda. https://​seer.​cancer.​gov/​csr/​1975_​2016/​, based on November 2018 SEER data submission, posted to the SEER web site, April 2019.
22.
go back to reference Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2017 Sub (1973-2015) - Linked To County Attributes - Total U.S., 1969-2016 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2018, based on the November 2017 submission. Surveillance, Epidemiology, and End Results (SEER) Program (www.​seer.​cancer.​gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2017 Sub (1973-2015) - Linked To County Attributes - Total U.S., 1969-2016 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2018, based on the November 2017 submission.
23.
go back to reference Alba AC, Agoritsas T, Walsh M, et al. Discrimination and Calibration of Clinical Prediction Models: Users' Guides to the Medical Literature. JAMA. 2017;318(14):1377–84.CrossRef Alba AC, Agoritsas T, Walsh M, et al. Discrimination and Calibration of Clinical Prediction Models: Users' Guides to the Medical Literature. JAMA. 2017;318(14):1377–84.CrossRef
24.
go back to reference Travis WD, Giroux DJ, Chansky K, et al. The IASLC lung Cancer staging project proposals for the inclusion of Broncho-pulmonary carcinoid Tumors in the forthcoming (seventh) edition of the TNM classification for lung Cancer. J Thorac Oncol. 2008;3(11):1213–23.CrossRef Travis WD, Giroux DJ, Chansky K, et al. The IASLC lung Cancer staging project proposals for the inclusion of Broncho-pulmonary carcinoid Tumors in the forthcoming (seventh) edition of the TNM classification for lung Cancer. J Thorac Oncol. 2008;3(11):1213–23.CrossRef
25.
go back to reference Brown LM, Cooke DT, Jett JR, David EA. Extent of resection and lymph node assessment for clinical stage T1aN0M0 typical carcinoid Tumors. Ann Thorac Surg. 2018;105(1):207–13.CrossRef Brown LM, Cooke DT, Jett JR, David EA. Extent of resection and lymph node assessment for clinical stage T1aN0M0 typical carcinoid Tumors. Ann Thorac Surg. 2018;105(1):207–13.CrossRef
26.
go back to reference Yoon JY, Sigel K, Martin J, et al. Evaluation of the prognostic significance of TNM staging guidelines in lung carcinoid Tumors. J Thorac Oncol. 2019;14(2):184–92.CrossRef Yoon JY, Sigel K, Martin J, et al. Evaluation of the prognostic significance of TNM staging guidelines in lung carcinoid Tumors. J Thorac Oncol. 2019;14(2):184–92.CrossRef
27.
go back to reference Filosso PL, Ferolla P, Guerrera F, et al. Multidisciplinary management of advanced lung neuroendocrine tumors. J Thorac Dis. 2015;7:S163–71.PubMedPubMedCentral Filosso PL, Ferolla P, Guerrera F, et al. Multidisciplinary management of advanced lung neuroendocrine tumors. J Thorac Dis. 2015;7:S163–71.PubMedPubMedCentral
28.
go back to reference Filosso PL, Rena O, Guerrera F, et al. Clinical management of atypical carcinoid and large-cell neuroendocrine carcinoma: a multicentre study on behalf of the European Association of Thoracic Surgeons (ESTS) neuroendocrine tumours of the lung working group. Eur J Cardio-Thorac. 2015;48(1):55–64.CrossRef Filosso PL, Rena O, Guerrera F, et al. Clinical management of atypical carcinoid and large-cell neuroendocrine carcinoma: a multicentre study on behalf of the European Association of Thoracic Surgeons (ESTS) neuroendocrine tumours of the lung working group. Eur J Cardio-Thorac. 2015;48(1):55–64.CrossRef
29.
go back to reference Mezzetti M, Raveglia F, Panigalli T, et al. Assessment of outcomes in typical and atypical carcinoids according to latest WHO classification. Ann Thorac Surg. 2003;76(6):1838–42.CrossRef Mezzetti M, Raveglia F, Panigalli T, et al. Assessment of outcomes in typical and atypical carcinoids according to latest WHO classification. Ann Thorac Surg. 2003;76(6):1838–42.CrossRef
30.
go back to reference Yokomine K, Tada S, Uehara M, Suko H, Kamio T, Matsumoto T. Management of rectal carcinoid tumors - response. Gastrointest Endosc. 2003;58(4):641–2.CrossRef Yokomine K, Tada S, Uehara M, Suko H, Kamio T, Matsumoto T. Management of rectal carcinoid tumors - response. Gastrointest Endosc. 2003;58(4):641–2.CrossRef
31.
go back to reference Steuer CE, Behera M, Kim S, et al. Atypical carcinoid tumor of the lung a Surveillance, epidemiology, and end results database analysis. J Thorac Oncol. 2015;10(3):479–85.CrossRef Steuer CE, Behera M, Kim S, et al. Atypical carcinoid tumor of the lung a Surveillance, epidemiology, and end results database analysis. J Thorac Oncol. 2015;10(3):479–85.CrossRef
32.
go back to reference Yendamuri S, Gold D, Jayaprakash V, Dexter E, Nwogu C, Demmy T. Is sublobar resection sufficient for carcinoid Tumors? Ann Thorac Surg. 2011;92(5):1774–9.CrossRef Yendamuri S, Gold D, Jayaprakash V, Dexter E, Nwogu C, Demmy T. Is sublobar resection sufficient for carcinoid Tumors? Ann Thorac Surg. 2011;92(5):1774–9.CrossRef
33.
go back to reference Segelov E, Bergsland E, Card C, et al. The commonwealth neuroendocrine tumour collaboration (CommNETs) and north American neuroendocrine tumor society (NANETS) endorsement and update of European neuroendocrine tumor society (ENETS) best practice consensus for lung neuroendocrine tumors (LNET). Ann Oncol. 2018:29. Segelov E, Bergsland E, Card C, et al. The commonwealth neuroendocrine tumour collaboration (CommNETs) and north American neuroendocrine tumor society (NANETS) endorsement and update of European neuroendocrine tumor society (ENETS) best practice consensus for lung neuroendocrine tumors (LNET). Ann Oncol. 2018:29.
34.
go back to reference Horsch D, Schmid KW, Anlauf M, et al. Neuroendocrine tumors of the bronchopulmonary system (typical and atypical carcinoid tumors): current strategies in diagnosis and treatment. Conclusions of an expert meeting February 2011 in Weimar, Germany. Oncol Res Treat. 2014;37(5):266–76.CrossRef Horsch D, Schmid KW, Anlauf M, et al. Neuroendocrine tumors of the bronchopulmonary system (typical and atypical carcinoid tumors): current strategies in diagnosis and treatment. Conclusions of an expert meeting February 2011 in Weimar, Germany. Oncol Res Treat. 2014;37(5):266–76.CrossRef
35.
go back to reference Goldstraw P, Crowley JJ. The International Association for the Study of Lung Cancer international staging project on lung Cancer. J Thorac Oncol. 2006;1(4):281–6.CrossRef Goldstraw P, Crowley JJ. The International Association for the Study of Lung Cancer international staging project on lung Cancer. J Thorac Oncol. 2006;1(4):281–6.CrossRef
36.
go back to reference Seidel D, Zander T, Heukamp LC, et al. A Genomics-Based Classification of Human Lung Tumors. Sci Transl Med. 2013;5(209). Seidel D, Zander T, Heukamp LC, et al. A Genomics-Based Classification of Human Lung Tumors. Sci Transl Med. 2013;5(209).
37.
go back to reference Pusceddu S, Lo Russo G, Macerelli M, et al. Diagnosis and management of typical and atypical lung carcinoids. Crit Rev Oncol Hemat. 2016;100:167–76.CrossRef Pusceddu S, Lo Russo G, Macerelli M, et al. Diagnosis and management of typical and atypical lung carcinoids. Crit Rev Oncol Hemat. 2016;100:167–76.CrossRef
Metadata
Title
Prognostic nomogram for predicting long-term cancer-specific survival in patients with lung carcinoid tumors
Authors
Yanqi He
Feng Zhao
Qingbing Han
Yiwu Zhou
Shuang Zhao
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Carcinoid Tumor
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-07832-6

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