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

doi:10.3748/wjg.v30.i28.3403

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World Journal of Gastroenterology

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World J Gastroenterol. Jul 28, 2024; 30(28): 3403-3417
Published online Jul 28, 2024. doi: 10.3748/wjg.v30.i28.3403

Table 1 Clinicopathological data of patients with rectal neuroendocrine neoplasms, n (%)

	All (n = 1408)	n
Sex		1408
Female	591 (42.0)
Male	817 (58.0)
Age, year	51.9 (12.1)	1408
Size (cm)		1408
≤ 1	872 (61.9)
1-2	291 (20.7)
> 2	171 (12.1)
NA	74 (5.3)
Size (cm)	1.3 (1.2)	1334
Neoadjuvant therapy		1408
No	1385 (98.4)
Yes	23 (1.6)
Complete resection
No	48 (3.4)
Yes	1360 (96.6)
Pathological type		1408
NET	1307 (92.8)
NEC	71 (5.0)
MANEC	14 (1.0)
NA	16 (1.1)
Pathological grade,		1408
G1	1149 (81.6)
G2	158 (11.2)
G3	85 (6.0)
NA	16 (1.1)
T stage		1408
T1	1150 (81.7)
T2	140 (9.9)
T3	82 (5.8)
T4	36 (2.6)
Lymphatic metastasis		1408
No	1305 (92.7)
Yes	103 (7.3)
TNM stage		1408
I	1133 (80.5)
II	130 (9.2)
III	92 (6.5)
IV	53 (3.8)
Lymph vascular invasion		1408
No	1347 (95.7)
Yes	61 (4.3)
CgA		1408
Negative	1046 (74.3)
Positive	362 (25.7)
Syn		1408
Negative	381 (27.1)
Positive	1027 (72.9)
Adjuvant therapy		1408
No	1318 (93.6)
Yes	90 (6.4)

NET: Neuroendocrine tumor; NEC: Neuroendocrine carcinoma; MANEC: Mixed adenoneuroendocrine carcinoma; CgA: Chromogranin A; Syn: Synaptophysin.

Table 2 Characteristics of patients with rectal neuroendocrine neoplasms from training database and validation set (2010-2022), n (%)

	All	Training set	Validation set	P value
	n = 1183	n = 819	n = 364	P value
Sex				0.402
Female	504 (42.6)	356 (43.5)	148 (40.7)
Male	679 (57.4)	463 (56.5)	216 (59.3)
Age, year	51.7 (12.0)	51.5 (12.0)	52.3 (12.0)	0.291
Size, year	1.1 (1.0)	1.1 (1.0)	1.2 (1.2)	0.187
Size (cm)				0.300
≤ 1	819 (69.2)	568 (69.4)	251 (69.0)
1-2	246 (20.8)	176 (21.5)	70 (19.2)
> 2	118 (10.0)	75 (9.2)	43 (11.8)
PLR	126.1 (52.3)	126.6 (54.3)	124.9 (47.6)	0.588
NLR	2.3 (5.1)	2.2 (2.5)	2.5 (8.4)	0.559
PNI	54.1 (6.8)	54.2 (6.9)	53.9 (6.5)	0.455
Pathological type				0.824
NET	1134 (95.9)	786 (96.0)	348 (95.6)
NEC	44 (3.7)	29 (3.5)	15 (4.1)
MANEC	5 (0.4)	4 (0.5)	1 (0.3)
Pathological grade				0.876
G1	1020 (86.2)	705 (86.1)	315 (86.5)
G2	114 (9.6)	81 (9.9)	33 (9.1)
G3	49 (4.1)	33 (4.0)	16 (4.4)
T stage				0.358
T1	1010 (85.4)	707 (86.3)	303 (83.2)
T2	111 (9.4)	74 (9.0)	37 (10.2)
T3	45 (3.8)	29 (3.5)	16 (4.4)
T4	17 (1.4)	9 (1.1)	8 (2.2)
Lymphatic metastasis				0.290
No	1107 (93.6)	771 (94.1)	336 (92.3)
Yes	76 (6.4)	48 (5.9)	28 (7.7)
TNM stage				0.227
I	996 (84.2)	699 (85.3)	297 (81.6)
II	108 (9.1)	71 (8.7)	37 (10.2)
III	79 (6.7)	49 (6.0)	30 (8.2)
Lymph vascular invasion				0.252
No	1149 (97.1)	799 (97.6)	350 (96.2)
Yes	34 (2.9)	20 (2.4)	14 (3.8)
CgA				0.100
Negative	871 (73.6)	615 (75.1)	256 (70.3)
Positive	312 (26.4)	204 (24.9)	108 (29.7)
Syn				0.393
Negative	297 (25.1)	212 (25.9)	85 (23.4)
Positive	886 (74.9)	607 (74.1)	279 (76.6)
Adjuvant therapy				0.286
No	1125 (95.1)	783 (95.6)	342 (94.0)
Yes	58 (4.9)	36 (4.4)	22 (6.0)

PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; PNI: Prognostic nutritional index; NET: Neuroendocrine tumor; NEC: Neuroendocrine carcinoma; MANEC: Mixed adenoneuroendocrine carcinoma; CgA: Chromogranin A; Syn: Synaptophysin.

Table 3 Univariate and multivariate analysis of clinicopathologic variables in relation to overall survival and progression free survival in patients with rectal neuroendocrine neoplasms

	Univariate analysis¹		Multivariate analysis¹		Univariate analysis²		Multivariate analysis²
	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
Sex (male)	1.148 (0.588-2.243)	0.686			1.168 (0.648-2.106)	0.605
Age (> 60)	2.194 (1.115-4.317)	0.023			2.875 (1.505-5.495)	< 0.001
PLR (> 128.00)	1.592 (0.818-3.100)	0.171			1.313 (0.668-2.577)	0.402
NLR (> 1.45)	1.629 (0.740-3.585)	0.226			2.322 (1.106-4.874)	0.007
PNI (> 46.57)	0.144 (0.071-0.295)	0.023	0.233 (0.109-0.499)	< 0.001	0.130 (0.043-0.392)	< 0.001	0.365 (0.135-0.583)	0.010
Size (cm)
≤ 1	-	Ref.	-	Ref.	-	Ref.
1-2	6.190 (2.591-14.790)	< 0.001	1.706 (0.538-5.413)	0.364	4.960 (1.956-12.580)	0.001
> 2	13.439 (5.563-32.468)	< 0.001	3.349 (1.314-8.533)	0.011	10.240 (5.200-25.200)	< 0.001
Pathological type
NET	-	Ref.			-	Ref.
NEC	31.177 (14.961-64.968)	< 0.001			15.121 (5.590-59.102)	< 0.001
MANEC	27.899 (6.399-121.627)	< 0.001			26.252 (6.203-85.32)	< 0.001
Pathological grade
G1	-	Ref.	-	Ref.	-	Ref.	-	Ref.
G2	6.380 (2.582-15.768)	0.001	4.211 (1.603-11.059)	0.004	8.680 (2.830-20.602)	< 0.001	2.937 (1.011-8.535)	0.048
G3	48.175 (21.495-107.969)	< 0.001	30.681 (10.821-86.988)	< 0.001	25.362 (6.362-62.325)	< 0.001	7.126 (2.685-18.913)	< 0.001
T stage
T1	-	Ref.			-	Ref.	-	Ref.
T2	3.234 (1.169-8.945)	0.024			13.370 (3.794-47.086)	< 0.001	2.136 (1.236-5.362)	0.025
T3	17.473 (7.846-38.915)	< 0.001			12.630 (2.635-18.354)	< 0.001	6.653 (2.368-15.362)	0.001
T4	23.081 (8.328-63.964)	< 0.001			26.368 (5.364-53.258)	< 0.001	8.365 (3.325-13.325)	< 0.001
Lymph node metastasis (yes)	11.387 (5.786-22.409)	< 0.001			12.440 (4.172-37.112)	< 0.001
TNM stage
I	-	Ref.			-	Ref.
II	3.280 (1.188-9.056)	0.022			6.839 (1.692-27.650)	0.006
III	14.524 (7.080-29.797)	< 0.001			17.792 (5.982-52.932)	< 0.001
Lymph vascular invasion (yes)	5.753 (2.013-16.447)	0.001			5.899 (1.213-28.703)	< 0.001
CgA (positive)	1.992 (1.012-3.919)	0.046			1.188 (0.608-2.322)	0.512
Syn (positive)	1.161 (0.541-2.492)	0.702			0.960 (0.483-1.908)	0.919
Adjuvant therapy (yes)	10.775 (5.161-22.499)	< 0.001			13.110 (3.737-45.962)	< 0.001

¹Overall survival.

²Progress free survival.

Citation: 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(28): 3403-3417
URL: https://www.wjgnet.com/1007-9327/full/v30/i28/3403.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i28.3403