Prognostic score in high-grade gastrointestinal neuroendocrine carcinomas (GI-NECS)

A Lamarca, J Barriuso, Mairead Mcnamara, R Hubner, JW Valle

    Research output: Contribution to conferencePoster


    Background Outcomes of patients with high-grade GI-NETs are poor. Ki-67 alone is a poorly informative prognostic marker; alternatives for risk-stratification are required. Material and Methods Consecutive patients, diagnosed with high-grade GI-NETs (1997-2014), were eligible. Prognostic factors were identified by the Log-rank test, Cox and logistic regression; ROC curve comparisons were performed for prediction accuracy. Internal validation of score was performed. Results We identified 109 eligible patients (median follow-up 9.7 months (1.3-102.9)). Median age: 67.7 years (16.3-84.1); 62% male, 84% metastatic; 19% foregut, 19% pancreas, 5% midgut, 28% hindgut and 29% unknown primary. Median Ki-67: 70% (range 20-100); performance status (PS) 0: 26%, 1: 52%; 70% received chemotherapy. Baseline median alkaline phosphatase (ALK) and lactate dehydrogenase (LDH) were 109 IU/l (range 45-2035) and 70 IU/l (range 258-11069), respectively. The score, selected by the lowest Akaike Index Criterion, included liver metastases, PS, Ki-67, LDH and ALK with 0-6 points assigned to each, resulting in 4 risk groups (A-D) with predicted risk of death as follows: median overall survival (OS) for group A, B, C and D was 20.4 months (95%CI 12.9-30.8), 9.9 (95%CI 7.6-14.3), 5.2 (95%CI 1.9-13.3) and 3.1 (95%CI 2.3-4.2), respectively. Prediction accuracy was maintained between the maximum model and the proposed score. On multivariable analysis, the score was prognostic for OS (HR 1.95, 95%CI 1.55-2.47; p
    Original languageEnglish
    Publication statusPublished - 2015
    EventUKINETS - London
    Duration: 7 Dec 20157 Dec 2015




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