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Background <p>Pancreatic neuroendocrine tumors (pNETs) are rare malignant tumors. While surgical resection is the primary therapeutic approach, postoperative survival outcomes remain suboptimal. This study aims to investigate the prognostic value of inflammation and nutrition-related indicators, such as Prognostic nutritional index (PNI), Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR), Systemic immune-inflammation index (SII), and Lymphocyte-monocyte ratio (LMR), in patients with pNETs undergoing surgery. Furthermore, we sought to develop and validate a prognostic nomogram incorporating independent predictors of postoperative overall survival (OS).</p> Methods <p>A retrospective analysis was conducted on the clinical data from 102 patients with pathologically confirmed pNETs. Univariate and multivariate Cox regression analyses were performed to identify prognostic factors. A nomogram was developed based on independent risk factors, and its predictive performance was internally validated.</p> Results <p>The analysis revealed that low preoperative levels of PNI, low NLR, low LMR, low SII, and low PLR were significantly associated with reduced postoperative survival. Multivariate Cox regression analysis identified PNI (HR = 0.153; 95% CI, 0.033–0.720), NLR (HR = 0.153; 95% CI, 0.037–0.633), and AJCC stage (HR = 20.126; 95% CI, 5.036–80.422) as independent prognostic factors. The developed nomogram demonstrated excellent discriminative ability, with time-dependent AUC values of 0.878 (3-year), 0.860 (5-year), and 0.830 (10-year), along with a C-index of 0.824 (95% CI 0.748, 0.901) upon internal validation. Risk stratification using the nomogram effectively distinguished low- and high-risk groups, and its validity was confirmed using Kaplan-Meier survival curves.</p> Conclusion <p>Despite limitations inherent to its retrospective, single-center design and small sample size, this study establishes a novel nomogram integrating inflammatory-nutritional biomarkers with clinicopathological staging. This tool provides clinicians with a personalized prognostic assessment framework to guide postoperative management strategies for pNETs patients.</p>

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Development and validation of a prognostic nomogram based on inflammation and Nutrition-Related Indexes for predicting postoperative survival in patients with pancreatic neuroendocrine tumors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • Nanwei Ye,
  • Ming Jin,
  • Yuancong Jiang,
  • Jie Qiu,
  • Zhenzhen Gao,
  • Sheng Yan,
  • Bo Zhou

摘要

Background

Pancreatic neuroendocrine tumors (pNETs) are rare malignant tumors. While surgical resection is the primary therapeutic approach, postoperative survival outcomes remain suboptimal. This study aims to investigate the prognostic value of inflammation and nutrition-related indicators, such as Prognostic nutritional index (PNI), Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR), Systemic immune-inflammation index (SII), and Lymphocyte-monocyte ratio (LMR), in patients with pNETs undergoing surgery. Furthermore, we sought to develop and validate a prognostic nomogram incorporating independent predictors of postoperative overall survival (OS).

Methods

A retrospective analysis was conducted on the clinical data from 102 patients with pathologically confirmed pNETs. Univariate and multivariate Cox regression analyses were performed to identify prognostic factors. A nomogram was developed based on independent risk factors, and its predictive performance was internally validated.

Results

The analysis revealed that low preoperative levels of PNI, low NLR, low LMR, low SII, and low PLR were significantly associated with reduced postoperative survival. Multivariate Cox regression analysis identified PNI (HR = 0.153; 95% CI, 0.033–0.720), NLR (HR = 0.153; 95% CI, 0.037–0.633), and AJCC stage (HR = 20.126; 95% CI, 5.036–80.422) as independent prognostic factors. The developed nomogram demonstrated excellent discriminative ability, with time-dependent AUC values of 0.878 (3-year), 0.860 (5-year), and 0.830 (10-year), along with a C-index of 0.824 (95% CI 0.748, 0.901) upon internal validation. Risk stratification using the nomogram effectively distinguished low- and high-risk groups, and its validity was confirmed using Kaplan-Meier survival curves.

Conclusion

Despite limitations inherent to its retrospective, single-center design and small sample size, this study establishes a novel nomogram integrating inflammatory-nutritional biomarkers with clinicopathological staging. This tool provides clinicians with a personalized prognostic assessment framework to guide postoperative management strategies for pNETs patients.