The PANEN nomogram: clinical decision support for patients with metastatic pancreatic neuroendocrine neoplasm referred for peptide receptor radionuclide therapy.

Introduction: Patients with pancreatic neuroendocrine neoplasms (P-NEN) may benefit from peptide receptor radionuclide therapy (PRRT). Prediction of overall survival (OS) using statistical models has the potential to guide treatment decisions. In this study, we have generated a clinicopathological and imaging parameter-based internally validated nomogram of patients who received PRRT for metastatic P-NEN to facilitate treatment decision support for the clinical management of such patients. Patients and methods: We reviewed 447 pancreatic NEN patients treated with PRRT. Clinical variables for the prediction of overall survival (OS) included age, gender, Karnofsky performance score (KPS), weight loss, hepatomegaly, time from diagnosis to first PRRT (days), tumor functionality, presence of Hedinger syndrome, presence of liver metastases, presence of bone metastases, presence of lung metastases, alkaline phosphatase, 2-deoxy-2-[18F]fluoro-D-glucose ([ Results: Median follow up time was 2045 days (min 136 days, max 10329 days). Time from diagnosis to 1 Conclusion: This study proposes an internally validated nomogram (PANEN-N) to accurately predict overall survival for P-NEN patients following PRRT, which could be used for patient counseling to facilitate informed and shared decision support in daily clinical practice as well as for generating new hypotheses.