Risk factors for lymph node metastasis in rectal neuroendocrine tumors: A recursive partitioning analysis based on multicenter data

Wang, Ye; Zhang, Yiyi; Lin, Hui; Xu, Meifang; Zhou, Xin; Zhuang, Jinfu; Yang, Yuanfeng; Chen, Bin; Liu, Xing; Guan, Guoxian

doi:10.1002/jso.26615

Cited by 11 publications

(12 citation statements)

References 27 publications

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“…A previous study reported that lymphatic invasion and lymph node metastasis rates increase significantly in cases of multiple lesions in patients with rectal NETs [ 32 ]. Furthermore, lymph node metastasis of rectal NETs has been associated with tumor size, depth of invasion, vascular invasion, and WHO grade, which is consistent with our findings for GEP-NET [ 33 ]. In addition, lymph node metastasis has been reported to affect prognosis.…”

Section: Discussionsupporting

confidence: 91%

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors: A Retrospective Analysis

Kohno

Ikegami

et al. 2021

JCM

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Neuroendocrine tumors develop from systemic endocrine and nerve cells, and their occurrence has increased recently. Since these tumors are heterogeneous, pathological classification has been based on the affected organ. In 2019, the World Health Organization introduced a change expected to influence neuroendocrine tumor research, as gastroenteropancreatic neuroendocrine tumors are now included within a unified classification. This retrospective study aimed to investigate the characteristics (e.g., lymph node metastases and all other metastases) of gastroenteropancreatic neuroendocrine tumors using this new classification in 50 cases. Tumor size, depth, MIB-1 index, lymphatic invasion, venous invasion, and neuroendocrine tumor grade were significantly correlated with lymph node metastasis and other metastases. The venous invasion was more strongly correlated with lymph node metastasis and all other types of metastases than with lymphatic invasion. Identification rates for lymphatic invasion were considered lower because of structural problems such as lymphatic vessels being much thinner than veins. However, venous invasion was considered effective in compensating for the low identification rate in cases of lymphatic invasion. In future research, a unified classification and standardized framework for assessment will be important when analyzing the characteristics of neuroendocrine tumors, and large-scale studies are required.

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Section: Discussionsupporting

confidence: 91%

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors: A Retrospective Analysis

Kohno

Ikegami

et al. 2021

JCM

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“…To predict the pCR rates of the patients with LARC after NCRT, the RPA was performed to classify patients with LARC into different risk groups. RPA was a useful statistical method for predicting patient risk in a number of cancers, including colorectal cancer, nasopharyngeal cancer, cervical cancer, and breast cancer, which could assist clinicians to determine the best medication regimen (30,(47)(48)(49). However, few studies used the RPA to forecast the NCRT response in patients with LARC.…”

Section: Discussionmentioning

confidence: 99%

“…Least absolute shrinkage and selection operator (LASSO) Cox regression model was applied to determine the ideal coefficient for each prognostic feature and estimate the likelihood deviance ( 28 , 29 ). Recursive partitioning analysis (RPA) was used to construct a decision tree that divides patients into different homogeneous risk groups by using the R project ( 30 ). Statistical significance was defined as P < 0.05.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of mesorectal package area in patients with locally advanced rectal cancer following neoadjuvant chemoradiotherapy: A retrospective cohort study

Guan

Huang²,

Huang³

et al. 2022

Front. Oncol.

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BackgroundThe aim of this study is to explore the most effective inflammation, magnetic resonance imaging (MRI), and nutrition markers for survival and pathology complete response (pCR) in patients with locally advanced rectal cancer (LARC).MethodsA total of 278 patients with LARC undergoing neoadjuvant chemoradiotherapy (NCRT) and radical surgery from 2016 to 2019 were included. The X-tile method was used to select the optimal cutoff points for the mesorectal package area (MPA), advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) scores. Cox regression analysis was used to identify risk factors of disease-free survival (DFS). To discover pCR risk factors, logistic regression analysis was employed. A predictive nomogram for DFS was constructed.ResultsAccording to the least absolute shrinkage and selection operator analysis, the MPA was the only significant predictor for the DFS in patients with LARC. Kaplan-Meier (K-M) analysis demonstrated that groups with higher MPA, PNI, SII, NLR, MLR, and ALI score had improved DFS (all P < 0.05). Receiver operating characteristic (ROC) analysis revealed that the MPA and PNI could accurately predict the pCR in patients with LARC after NCRT. The MPA score and NLR score were found to be independent predictors of DFS after NCRT using Cox regression analysis. Logistical regression analysis demonstrated that the MPA score, PNI score, and pre-NCRT cN stage were all independent predictors of pCR in patients with LARC after NCRT. Recursive partitioning analysis and time-independent ROC curve analysis demonstrated that MPA score was the most important predictor of pCR and prognosis in patients with LARC after NCRT.ConclusionsMPA was identified as the most effective marker for MRI, and the prognostic value was further confirmed by time–ROC analysis. More intense adjuvant treatment could be considered for lower–MPA score patients with LARC after NCRT. Obesity in the pelvis encourages the understanding of the prognosis prediction of patients with LARC after NCRT.

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“…As a statistical method of multivariate analysis, RPA divides patients into different homogeneous risk groups by constructing a decision tree and divides predictors into several groups,whose effects have been reported many times [11,12]. In every node, each predictor was examined for the best split within that variable and the optimal split it corresponds to, which has the greatest difference between patient groups.…”

Section: Recursive Partitioning Analysis (Rpa)mentioning

confidence: 99%

A good preoperative immune prognostic index is predictive of better prognosis for locally advanced rectal cancer patients with ypTNM stage II who underwent radical resection after neoadjuvant chemoradiotherapy

Wang

Cai

et al. 2023

Preprint

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Background: No studies have investigated the role of IPI in assessing the prognosis for LARC patients undergoing nCRT. Objective: We attempted to combine neutrophil-to-lymphocyte ratio (NLR) and serum lactate dehydrogenase (sLDH) to generate a new rectal immune prognostic index (RIPI) to explore whether RIPI is associated with the prognosis of LARC. And try to find out whether there is a population that might benefit from RIPI in LARC. Methods: Locally advanced rectal cancer (LARC) patients who underwent radical surgery after Neoadjuvant chemoradiotherapy (nCRT) from February 2012 to May 2017 were enrolled. Based on the best cut-off points of NLR and sLDH, we developed rectal immune prognostic index (RIPI). Patients were grouped as follows: 1) good, RIPI = 0, good, 0 factors; 2) poor, RIPI = 1, 1 or 2 factors. Results: A total of 642 patients were enrolled. In yp TNM stage II patients, there was a statistically significant difference in 5-year disease-free survival (DFS) (p=0.03) between RIPI=1 and RIPI=0 groups. In ypCR, stage I, stage II, and stage III, there was no significant difference in 5-year DFS between IPI=0 and IPI=1 groups. In multivariate analysis, the significant factor predicting DFS was RIPI score (p=0.035) Conclusion: RIPI was closely related to the prognosis of LARC patients undergoing nCRT. In particular, RIPI is of great significance in evaluating the prognosis of LARC patients with ypTNM stage II who underwent radical resection after nCRT.

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Risk factors for lymph node metastasis in rectal neuroendocrine tumors: A recursive partitioning analysis based on multicenter data

Abstract: Background: The well-differentiated rectal neuroendocrine tumors (RNETs) can also have lymph node metastasis (LNM). Large multicenter data were reviewed to explore the risk factors for LNM in RNETs. Further, we developed a model to predict the risk of LNM in RNETs.

Cited by 11 publications

References 27 publications

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors: A Retrospective Analysis

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors: A Retrospective Analysis

Prognostic value of mesorectal package area in patients with locally advanced rectal cancer following neoadjuvant chemoradiotherapy: A retrospective cohort study

A good preoperative immune prognostic index is predictive of better prognosis for locally advanced rectal cancer patients with ypTNM stage II who underwent radical resection after neoadjuvant chemoradiotherapy

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