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Zeng XY, Zhong M, Lin GL, Li CG, Jiang WZ, Zhang W, Xia LJ, Di MJ, Wu HX, Liao XF, Sun YM, Yu MH, Tao KX, Li Y, Zhang R, Zhang P. GATIS score for predicting the prognosis of rectal neuroendocrine neoplasms: A Chinese multicenter study of 12-year experience. World J Gastroenterol 2024; 30:3403-3417. [PMID: 39091717 PMCID: PMC11290398 DOI: 10.3748/wjg.v30.i28.3403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/04/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND There is currently a shortage of accurate, efficient, and precise predictive instruments for rectal neuroendocrine neoplasms (NENs). AIM To develop a predictive model for individuals with rectal NENs (R-NENs) using data from a large cohort. METHODS Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in China. Random forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival, and two nomograms were constructed. RESULTS A total of 1408 patients with R-NENs were included. Tumor grade, T stage, tumor size, age, and a prognostic nutritional index were important risk factors for prognosis. The GATIS score was calculated based on these five indicators. For overall survival prediction, the respective C-indexes in the training set were 0.915 (95% confidence interval: 0.866-0.964) for overall survival prediction and 0.908 (95% confidence interval: 0.872-0.944) for progression-free survival prediction. According to decision curve analysis, net benefit of the GATIS score was higher than that of a single factor. The time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time periods. CONCLUSION The GATIS score had a good predictive effect on the prognosis of patients with R-NENs, with efficacy superior to that of the World Health Organization grade and TNM stage.
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Affiliation(s)
- Xin-Yu Zeng
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, Hubei Province, China
| | - Ming Zhong
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Guo-Le Lin
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100730, China
| | - Cheng-Guo Li
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, Hubei Province, China
| | - Wei-Zhong Jiang
- Department of Colorectal Surgery, Fujian Medical University, Fuzhou 350401, Fujian Province, China
| | - Wei Zhang
- Department of Colorectal Surgery, Changhai Hospital, Shanghai 200433, China
| | - Li-Jian Xia
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 250118, Shandong Province, China
| | - Mao-Jun Di
- Department of Gastrointestinal Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan 442099, Hubei Province, China
| | - Hong-Xue Wu
- Department of Gastrointestinal Surgery I Section, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Xiao-Feng Liao
- Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, Hubei Province, China
| | - Yue-Ming Sun
- Department of Colorectal Surgery, Jiangsu Province Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Min-Hao Yu
- Department of Gastrointestinal Surgery, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Kai-Xiong Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, Hubei Province, China
| | - Yong Li
- Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
| | - Rui Zhang
- Department of Colorectal Surgery, Liaoning Cancer Hospital, Shenyang 110042, Liaoning Province, China
| | - Peng Zhang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, Hubei Province, China
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Sui C, Lin C, Tao T, Huang Y, Zhang H, Yu H, Tao L, Wang M, Wang F. Controlling Nutritional Status (CONUT) score as a prognostic marker for gastrointestinal stromal tumours. ANZ J Surg 2023; 93:2125-2131. [PMID: 37338039 DOI: 10.1111/ans.18573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/12/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND The Controlling Nutritional Status (CONUT) score, regarded as the effective indicator of patient nutrition, has been demonstrated to be related to prognosis of numerous tumours. Nevertheless, the significance of CONUT for gastrointestinal stromal tumour (GIST) remains unclear. This study intended to clarify the association between CONUT and the prognosis of GISTs. METHODS Three hundred and fifty-five patients with GISTs undergoing surgical resection at our center were retrospectively assessed. Receiver operating characteristic curve analysis was used to help determine the cut-off value of CONUT score. Relapse-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier curve analysis. Prognostic factors for RFS and OS were examined by Cox proportional hazards models. RESULTS A total of 355 patients were enrolled in this study. Areas under the curve (AUC) were 0.638 for CONUT score, and the cut-off value of CONUT was shown to be three. Kaplan-Meier curve analysis showed that high CONUT score was linked to poorer RFS and OS. Univariate and multivariate analyses ultimately revealed that CONUT was a risk factor for RFS and OS, independent of demographics and clinicopathological tumour characteristics. CONCLUSIONS CONUT score was an effective and novel predictor for prognosis of GIST patients treated with surgery, indicating its potential as a prognostic marker in the overall management.
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Affiliation(s)
- Chao Sui
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chen Lin
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tingting Tao
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yibo Huang
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Haoran Zhang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Heng Yu
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Liang Tao
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Meng Wang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Feng Wang
- Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
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Li Z, Zhang D, Mo C, Zhu P, Fan X, Tang T. The prognostic significance of prognostic nutritional index in gastrointestinal stromal tumors: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32067. [PMID: 36451460 PMCID: PMC9704956 DOI: 10.1097/md.0000000000032067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Risk assessment before treatment is important for gastrointestinal stromal tumors (GISTs), which will determine the priority of surgery or preoperative treatment. The prognostic nutritional index (PNI) is an integrated parameter consisting of serum albumin and lymphocyte count. Immunonutritional status defined in this manner is well-known to be closely linked to the prognosis of several other cancers. Nevertheless, the prognostic value of PNI specifically in GISTs has not been well-established. This study aimed to verify the prognostic role of PNI in patients with GISTs. METHODS A comprehensive literature search was conducted on medical databases up to June, 2022, and the raw data (hazard ratios and 95% confidence intervals [CIs]) focusing on the prognostic value of PNI in patients with GISTs regarding recurrence-free survival were extracted and synthesized adopting the random-effects model. This review was registered in the PROSPERO database (CRD42022345440). RESULTS A total of 8 eligible studies including 2627 patients with GISTs was analyzed and the pooled results confirmed that an elevated PNI was associated with a better recurrence-free survival (hazard ratio: 0.52, 95% CI: 0.40-0.68), with a moderate heterogeneity (I-square, 38%). The findings from subgroup analysis were consistent with the overall pooled results, and a sensitivity analysis, not the subgroup analysis, identified the source of heterogeneity. CONCLUSION Elevated pretreatment PNI may be a useful indicator for assessing risk of recurrence in patients from China with GISTs. Studies in other countries and regions are needed to further verify the prognostic value of PNI in GISTs.
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Affiliation(s)
- Zhenjie Li
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Dengming Zhang
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Chunlin Mo
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Peijin Zhu
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Xiaoxi Fan
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Tingyong Tang
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
- * Correspondence: Tingyong Tang, Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan 528100, China (e-mail: )
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