Competing risks and cause-specific mortality in patients with pancreatic neuroendocrine tumors.

Abstract:

BACKGROUND AND OBJECTIVE:Currently, there are no competing risk analyses of cause-specific mortality in patients with pancreatic neuroendocrine tumors. MATERIALS AND METHODS:We estimated a cumulative incidence function for cause-specific mortality. The first nomogram for predicting cause-specific mortality was constructed using a proportional subdistribution hazard model, validated using bootstrap cross-validation, and evaluated with decision curve analysis. RESULTS:Sex, age, positive lymph node status, metastasis, surveillance, epidemiology, and end results historic stage, grade, and surgery strongly predicted cause-specific mortality. The discrimination performance of Fine-Gray models was evaluated using the c-index, which was 0.864. In addition, the calibration plot of the developed nomogram demonstrated good concordance between the predicted and actual outcomes. Decision curve analysis yielded a range of threshold probabilities (0.014-0.779) at which the clinical net benefit of the risk model was greater than that in hypothetical all-screening or no-screening scenarios. CONCLUSION:Our nomogram allows selection of a patient population at high risk for cancer-specific mortality and thus facilitates the design of prevention trials for the affected population.

authors

Li Z,Du S,Feng W,Zhang W,Li G,Wei J,Zhang G,Zhao L

doi

10.1097/MEG.0000000000001350

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

749-755

issue

7

eissn

0954-691X

issn

1473-5687

journal_volume

31

pub_type

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