Impact of Combined Chemotherapy and Targeted Therapy on Pancreatic Neuroendocrine Carcinoma with Liver Metastasis: A Single-Center Modified Nomogram Analysis

Figures & data

Figure 1 This flowchart illustrates the process for selecting patients with pNEC and liver metastasis.

Table 1 Characteristics of 45 Patients with Pancreatic Neuroendocrine Carcinoma Liver Metastasis

Variable	Value
Gender
Female	23 (51.1%)
Male	22 (48.9%)
Age (years)
≤60	14 (31.1%)
>60	31 (68.9%)
Median, IQR	53, 17
Tumor size (cm)
≤5	35 (77.8%)
>5	10 (22.2%)
Median, IQR	4.4, 1.8
Primary tumor resection
Yes	30 (66.7%)
No	15 (33.3%)
Treatment
Chemotherapy combined targeted therapy	12 (26.7%)
Chemotherapy or targeted therapy	25 (55.6%)
No chemotherapy or targeted therapy	8 (17.8%)

Table 2 Univariate Cox Analysis for OS of Patients

Variable	HR	P
Gender
Female	Reference
Male	1.048 (0.577–1.903)	0.879
Age (years)	1.009 (0.980–1.039)	0.549
Tumor size (cm)	1.293 (1.076–1.554)	0.006
Primary tumor resection
Yes	Reference
No	2.940 (1.478–5.852)	0.002
Treatment
Chemotherapy combined targeted therapy	Reference
Chemotherapy or targeted therapy	1.885 (0.899–3.953)	0.093
No chemotherapy or targeted therapy	4.024 (1.539–10.525)	0.005

Table 3 Multivariate Cox Analysis for OS of Patients

Variable	HR	P
Tumor size	1.457 (1.199–1.770)	<0.001
Primary tumor resection
Yes	Reference
No	5.666 (2.611–12.296)	<0.001
Treatment
Chemotherapy combined targeted therapy	Reference
Chemotherapy or targeted therapy	2.361 (1.098–5.077)	0.028
No chemotherapy or targeted therapy	7.804 (2.729–22.319)	<0.001

Figure 2 Kaplan-Meier curves demonstrate differences in OS among pNEC patients with liver metastasis concerning: (a) PTR, (b) Tumor size, (c) Chemotherapy or targeted therapy.

Table 4 The Predictable and Referable Table for Survival

Factors	OS
Size (cm)	Points
1	0
2	11
3	22
4	33
5	44
6	56
7	67
8	78
9	89
10	100
Primary tumor resection
Yes	0
No	51
Chemotherapy
Chemotherapy combined targeted therapy	0
Chemotherapy or targeted therapy	25
No chemotherapy or targeted therapy	61
Total Points 1-year survival
0.05	142
0.1	134
0.15	128
0.2	123
0.25	119
0.3	115
0.35	111
0.4	107
0.45	103
0.5	98
0.55	94
0.6	89
0.65	84
0.7	79
0.75	73
0.8	65
0.85	56
0.9	43
0.95	22
Total Points 3-year survival
0.05	107
0.1	99
0.15	93
0.2	88
0.25	84
0.3	80
0.35	76
0.4	72
0.45	68
0.5	63
0.55	59
0.6	54
0.65	49
0.7	44
0.75	37
0.8	30
0.85	21
0.9	8
Total Points 5-year survival
0.05	88
0.1	80
0.15	75
0.2	70
0.25	65
0.3	61
0.35	57
0.4	53
0.45	49
0.5	45
0.55	41
0.6	36
0.65	31
0.7	25
0.75	19
0.8	11
Points per unit of linear predictor	29.528
Linear predictor units per point	0.034

Figure 3 A modified nomogram predictive model for OS is depicted.

Figure 4 Validation of the prediction model: (a) Calibration plots of nomogram predictions, (b) Bootstrap validation to verify the C-index and its 95% CI for the nomogram regarding OS.

Data Sharing Statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.