title: A Novel Nomogram to Predict the Prognosis of Patients Undergoing Liver Resection for Neuroendocrine Liver Metastasis: an Analysis of the Italian Neuroendocrine Liver Metastasis Database.
abstract: Even though surgery remains the only potentially curative option for patients with neuroendocrine liver metastases, the factors determining a patient's prognosis following hepatectomy are poorly understood. Using a multicentric database including patients who underwent hepatectomy for NELMs at seven tertiary referral hepato-biliary-pancreatic centers between January 1990 and December 2014, we sought to identify the predictors of survival and develop a clinical tool to predict patient's prognosis after liver resection for NELMs. The median age of the 238 patients included in the study was 61.9 years (interquartile range 51.5-70.1) and 55.9 % (n = 133) of patients were men. The number of NELMs (hazard ratio = 1.05), tumor size (HR = 1.01), and Ki-67 index (HR = 1.07) were the predictors of overall survival. These variables were used to develop a nomogram able to predict survival. According to the predicted 5-year OS, patients were divided into three different risk classes: 19.3, 55.5, and 25.2 % of patients were in low (>80 % predicted 5-year OS), medium (40-80 % predicted 5-year OS), and high (<40 % predicted 5-year OS) risk classes. The 10-year OS was 97.0, 55.9, and 20.0 % in the low, medium, and high-risk classes, respectively (p < 0.001). We developed a novel nomogram that accurately (c-index >70 %) staged and predicted the prognosis of patients undergoing liver resection for NELMs.
authors: General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy.
authors: Andrea
authors: A
authors: Ruzzenente
authors: General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy.
authors: Fabio
authors: 0000-0002-5386-0958
authors: F
authors: Bagante
authors: General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy.
authors: Francesca
authors: F
authors: Bertuzzo
authors: Hepatobiliary Surgery Division, Department of Surgery, IRCCS San Raffaele Hospital, School of Medicine, Milan, Italy.
authors: Luca
authors: L
authors: Aldrighetti
authors: General Surgery and Transplant Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, School of Medicine, Bologna, Italy.
authors: Giorgio
authors: G
authors: Ercolani
authors: Hepatobiliary Surgery Unit, A. Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy.
authors: Felice
authors: F
authors: Giuliante
authors: Department of General and Oncologic Surgery, Ospedale Mauriziano Umberto I, Turin, Italy.
authors: Alessandro
authors: A
authors: Ferrero
authors: Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas Reseach Hospital, Humanitas University, Rozzano, Milano, Italy.
authors: Guido
authors: G
authors: Torzilli
authors: Department of Surgery, Regina Elena National Cancer Institute, Rome, Italy.
authors: Gian Luca
authors: GL
authors: Grazi
authors: Hepatobiliary Surgery Division, Department of Surgery, IRCCS San Raffaele Hospital, School of Medicine, Milan, Italy.
authors: Francesca
authors: F
authors: Ratti
authors: General Surgery and Transplant Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, School of Medicine, Bologna, Italy.
authors: Alessandro
authors: A
authors: Cucchetti
authors: Hepatobiliary Surgery Unit, A. Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy.
authors: Agostino M
authors: AM
authors: De Rose
authors: Department of General and Oncologic Surgery, Ospedale Mauriziano Umberto I, Turin, Italy.
authors: Nadia
authors: N
authors: Russolillo
authors: Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas Reseach Hospital, Humanitas University, Rozzano, Milano, Italy.
authors: Matteo
authors: M
authors: Cimino
authors: Department of Surgery, Regina Elena National Cancer Institute, Rome, Italy.
authors: Pasquale
authors: P
authors: Perri
authors: Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy.|ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy.
authors: Ivana
authors: I
authors: Cataldo
authors: Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy.|ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy.
authors: Aldo
authors: A
authors: Scarpa
authors: General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy.
authors: Alfredo
authors: A
authors: Guglielmi
authors: General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy. Calogero.Iacono@univr.it.|Department of Surgery and Oncology, Division of General and Hepatobiliary Surgery, School of Medicine, University of Verona, P. le L.A. Scuro, 37134, Verona, Italy. Calogero.Iacono@univr.it.
authors: Calogero
authors: C
authors: Iacono
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D007558:Italy; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000556:secondary / Q000601:surgery*; D049451:Nomograms; D011379:Prognosis; D018570:Risk Assessment
keywords: Liver surgery; Neuroendocrine liver metastasis; Prognostic model