64 | wetenschapsdag 2023 Sessie 2b: Classificaties: van Chaos naar Categorie x2 Auteurs F.H. erdmann, E. kaçmaz, E.J.M. nieveen van dijkum, A.F. engelsman Abstract titel Prediction of recurrence for grade 1-2 small bowel neuroendocrine neoplasms after curative intended resection Background In patients with grade 1 to 2 SB-NEN reccurrence rates are reported up to 50%. No tools exist yet to identify patients at highrisk for recurrence in SB-NENs. Methods Patients with grade 1-2 SB-NEN who underwent curative intended resection in eight different European institutions were retrospectively identified. Patients were excluded if they were not diagnosed with grade 1-2 SB-NEN or if recurrence dates were missing. Multivariate Cox regression analysis was performed to identify independent prognostic factors for 5-year RFS. An internally validated nomogram was constructed based these factors and assessed by means of discrimination, calibration, and clinical utility. Results . Out of 173 patients included, 45 (26%) experienced loco-regional or distant recurrence with a mean 5-year RFS of 59%. Age, presence of distant metastasis and T-status were identified as independent prognostic factors. A nomogram was constructed based on these factors. Internally validated discrimination (concordance index 0.71 [95% CI 0.62 – 0.80]), calibration and clinical utility demonstrated the nomogram’s ability to identify highrisk patients (RFS 10 – 50%) for 5-year recurrence. Conclusion Age, presence of distant metastasis and T-status can be used as independent factors in this nomogram to identify high-risk patients for 5-year RFS after curative intended resection. The nomogram’s limitation to identify low-risk patients warrants future research including additional variables and external validation. Clinical trials should be set-up in the future based on these identifaction models to assess possibilities of adjuvant treatment in high-risk patients.
RkJQdWJsaXNoZXIy MTk4NDMw