A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation

BackgroundNeuroendocrine carcinoma of the cervix (NECC) is a rare and highly aggressive subtype of cervical carcinomas with poor prognosis. NECC tends to occur in young age which could severely impair mental and physical health of young patients. Therefore, this study aims to develop an individualiz...

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Main Authors: Ning Xie, Haijuan Yu, Jie Lin, Sufang Deng, Linying Liu, Yang Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1463422/full
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author Ning Xie
Haijuan Yu
Jie Lin
Sufang Deng
Linying Liu
Yang Sun
author_facet Ning Xie
Haijuan Yu
Jie Lin
Sufang Deng
Linying Liu
Yang Sun
author_sort Ning Xie
collection DOAJ
description BackgroundNeuroendocrine carcinoma of the cervix (NECC) is a rare and highly aggressive subtype of cervical carcinomas with poor prognosis. NECC tends to occur in young age which could severely impair mental and physical health of young patients. Therefore, this study aims to develop an individualized prognostic nomogram for young NECC patients.Methods360 young (≤45 years old) NECC patients were retrospectively selected from the Surveillance, Epidemiology and End Results (SEER) database and were randomly located to a training cohort and an internal validation cohort in a ratio of 7:3. Data from Fujian Cancer Hospital was used as an external validation cohort. Independent prognostic factors were identified by univariate and multivariate Cox regression analysis, and a prognostic nomogram for young NECC was developed. The predictive accuracy and clinical utility of the nomogram were assessed by area under the time-dependent receiver operating characteristic (timeROC) curve (AUC), the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Finally, a simplified scoring system for clinical use was constructed by dividing patients into high-risk and low-risk groups.ResultsPathological type, FIGO stage, and surgery were independent risk factors by univariate and multivariate analysis (P < 0.05). The prognostic nomogram consisting of the above three independent risk factors had high accuracy. The AUC values of 5-year overall survival (OS) in the training, internal validation, and external validation cohorts were 0.805, 0.798 and 0.872, respectively. The prognostic nomogram also presented with good C-index and calibration plots. The DCA curve further confirmed that the nomogram had a high clinical net benefit. According to the median prognostic index (median PI=18.6), all patients were categorized into high-risk group and low-risk group. The 5-year OS of the high-risk NECC group was significantly worse than that of the low-risk group among three cohorts (P<0.05).ConclusionsPathological type, FIGO stage, and surgery were identified as independent prognostic risk factors for young NECC patients. Based on the nomogram, gynecologic oncologists can accurately and easily predict the prognosis of young NECC and provide scientific guidance for individualized treatment.
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spelling doaj-art-7411f282da55457f8310233a300be3352025-01-31T05:10:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011510.3389/fonc.2025.14634221463422A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validationNing XieHaijuan YuJie LinSufang DengLinying LiuYang SunBackgroundNeuroendocrine carcinoma of the cervix (NECC) is a rare and highly aggressive subtype of cervical carcinomas with poor prognosis. NECC tends to occur in young age which could severely impair mental and physical health of young patients. Therefore, this study aims to develop an individualized prognostic nomogram for young NECC patients.Methods360 young (≤45 years old) NECC patients were retrospectively selected from the Surveillance, Epidemiology and End Results (SEER) database and were randomly located to a training cohort and an internal validation cohort in a ratio of 7:3. Data from Fujian Cancer Hospital was used as an external validation cohort. Independent prognostic factors were identified by univariate and multivariate Cox regression analysis, and a prognostic nomogram for young NECC was developed. The predictive accuracy and clinical utility of the nomogram were assessed by area under the time-dependent receiver operating characteristic (timeROC) curve (AUC), the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Finally, a simplified scoring system for clinical use was constructed by dividing patients into high-risk and low-risk groups.ResultsPathological type, FIGO stage, and surgery were independent risk factors by univariate and multivariate analysis (P < 0.05). The prognostic nomogram consisting of the above three independent risk factors had high accuracy. The AUC values of 5-year overall survival (OS) in the training, internal validation, and external validation cohorts were 0.805, 0.798 and 0.872, respectively. The prognostic nomogram also presented with good C-index and calibration plots. The DCA curve further confirmed that the nomogram had a high clinical net benefit. According to the median prognostic index (median PI=18.6), all patients were categorized into high-risk group and low-risk group. The 5-year OS of the high-risk NECC group was significantly worse than that of the low-risk group among three cohorts (P<0.05).ConclusionsPathological type, FIGO stage, and surgery were identified as independent prognostic risk factors for young NECC patients. Based on the nomogram, gynecologic oncologists can accurately and easily predict the prognosis of young NECC and provide scientific guidance for individualized treatment.https://www.frontiersin.org/articles/10.3389/fonc.2025.1463422/fullneuroendocrine carcinoma of the cervixyouthSEER databaseprognostic nomogramexternal validation
spellingShingle Ning Xie
Haijuan Yu
Jie Lin
Sufang Deng
Linying Liu
Yang Sun
A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
Frontiers in Oncology
neuroendocrine carcinoma of the cervix
youth
SEER database
prognostic nomogram
external validation
title A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
title_full A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
title_fullStr A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
title_full_unstemmed A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
title_short A nomogram for predicting prognosis for young cervical neuroendocrine carcinoma: A SEER-based study and external validation
title_sort nomogram for predicting prognosis for young cervical neuroendocrine carcinoma a seer based study and external validation
topic neuroendocrine carcinoma of the cervix
youth
SEER database
prognostic nomogram
external validation
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1463422/full
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