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Multicenter Study
. 2024 Jul 28;30(28):3403-3417.
doi: 10.3748/wjg.v30.i28.3403.

GATIS score for predicting the prognosis of rectal neuroendocrine neoplasms: A Chinese multicenter study of 12-year experience

Xin-Yu Zeng  1 , Ming Zhong  2 , Guo-Le Lin  3 , Cheng-Guo Li  1 , Wei-Zhong Jiang  4 , Wei Zhang  5 , Li-Jian Xia  6 , Mao-Jun Di  7 , Hong-Xue Wu  8 , Xiao-Feng Liao  9 , Yue-Ming Sun  10 , Min-Hao Yu  11 , Kai-Xiong Tao  1 , Yong Li  12 , Rui Zhang  13 , Peng Zhang  14
Affiliations
Multicenter Study

GATIS score for predicting the prognosis of rectal neuroendocrine neoplasms: A Chinese multicenter study of 12-year experience

Xin-Yu Zeng et al. World J Gastroenterol. .

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.

Keywords: Nomogram; Overall survival; Prognosis; Progression-free survival; Random forest; Rectal neuroendocrine neoplasm.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Patient selection flowchart. NENs: Neuroendocrine neoplasms.
Figure 2
Figure 2
The GATIS score. A: Nomogram for overall survival prediction; B: Nomogram for progression free survival prediction. PNI: Prognostic nutritional index; OS: Overall survival; PFS: Progression free survival.
Figure 3
Figure 3
Nomogram validation for overall survival prediction. A: Calibration plot of 3-year overall survival (OS) for the training set; B: Calibration plot of 5-year OS for the training set; C: Calibration plot of 3-year OS for the validation set; D: Calibration plot of 5-year OS for the validation set; E: The decision curve analysis for OS; F: Time-dependent area under the receiver operating characteristic curve analysis for OS. OS: Overall survival; PNI: Prognostic nutritional index; AUC: Area under the receiver operating characteristic curve.
Figure 4
Figure 4
Nomogram validation for progression free survival prediction. A: Calibration plot of 3-year progression free survival (PFS) for the training set; B: Calibration plot of 5-year PFS for the training set; C: Calibration plot of 3-year PFS for the validation set; D: Calibration plot of 5-year PFS for the validation set; E: The decision curve analysis for PFS; F: Time-dependent area under the receiver operating characteristic curve analysis for PFS. PFS: Progression free survival; PNI: Prognostic nutritional index; AUC: Area under the receiver operating characteristic curve.
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