Identification of characteristics and construction of nomogram to predict the survival probability of mesonephric carcinoma patients: A population-based analysis and a case report

BACKGROUND

Mesonephric carcinoma (MC) is a very rare tumor with less than 70 cases had been reported. The rarity of MC has restricted its research, resulting in the lack of published guidelines.

OBJECTIVE

To summarize the characteristics and construct an external-validated nomogram to predict the survival of MC patients.

METHOD

Sixty-four qualified patients derived from the Surveillance, Epidemiology, and End Results Plus database, and one patient from the Guangzhou Red Cross Hospital were enrolled. The entire cohort was randomly divided into a development (70%) and a validation cohort (30%). The Kaplan-Meier method and univariate and multivariate Cox regression analyses were applied. Two nomograms were established to predict the 3-to-8-year survival probability of MC patients, which were evaluated by C-index, ROC curves, DCA curves, and calibration plots.

RESULTS

The average survival time of MC patients was 84.22 ± 50.66 months. No significant difference was shown among different groups of race, primary site, tumor differentiated grade, and FIGO stages, while different SEER stages did distinguish patients' survival time, which indicated that the SEER stage standards might be a better staging system in the MC patients than FIGO stage (p = .0835). Additional survival analyses showed that MC patients benefited from shorter waiting times to begin treatment, accepting surgery, regional lymph node examination, radiotherapy, and chemotherapy. Two nomograms were established, both of which got satisfied scores in C-index, ROC curves, DCA curves, and calibration plots.

CONCLUSION

Sufficient regional lymph nodes examined, and applying radiotherapy in high-risk patients are recommended in MC patients. Nomograms established in the present study had good predicting and discriminating capabilities, which would be helpful in patients' individual risk estimation, management, counseling, and follow-up.

Incidence trend and conditional survival estimates of gastroenteropancreatic neuroendocrine tumors: A large population-based study

Given the rarity and indolent clinical course of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), conditional survival might be the most suitable parameter for cancer survivors who wish to receive accurate prognostic information during follow-up. We have explored the updated incidence trend and the conditional survival of patients with GEP-NETs. Incidence trends from 2000 to 2014 were determined through an assessment of patients in the SEER cancer registry. Patients diagnosed between 1988 and 2011 were included in the conditional survival analysis, and the 3-year conditional cancer-specific survival (CCS3) was computed. The incidence of GEP-NETs, which is far higher than the incidence of many malignant tumors, is still increasing steadily (annual percentage change = 4.4). The risk of death from NETs is dynamic over time, and most deaths occur in the first 3 years after diagnosis. Patients with gastric, rectal, or appendiceal NETs hardly exhibit any excess mortality (CCS3 > 95%) given that they have already survived until a defined time-point within 10 years. The initial difference between each age group basically disappeared with an extension of the survival time since the initial diagnosis of gastric, appendiceal, or rectal NETs, but the difference persisted for tumors at other sites. Although patients with advanced-stage or higher-grade tumors have a worse survival at diagnosis than patients with early-stage or lower-grade tumors, the difference diminishes and might even disappear over time. For GEP-NETs that are rare but exhibit slow growth, clinically relevant variations in conditional survival were observed based on the time since diagnosis. Therefore, conditional survival can serve as a guideline that can be used by cancer survivors to plan their future and doctors to plan surveillance schedules.