Chemotherapy was not independently associated with cancer-specific death in non-metastatic right-sided colon neuroendocrine carcinoma from SEER.

Authors

Danwei Du, Shijiao Nie, YangYang Xie, Ziqiang Wang, Xiaowen Li

Published in

Scientific reports. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

The prognostic value of postoperative chemotherapy for non-metastatic right-sided colon neuroendocrine carcinoma (RCNEC) remains unclear. This study aimed to evaluate its association with survival outcomes and to develop a prognostic nomogram for surgically treated RCNEC patients. Surgically treated non-metastatic high-grade RCNEC patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and were classified into chemotherapy and non-chemotherapy groups according to SEER-recorded chemotherapy status. Propensity score matching (PSM) was performed to balance baseline characteristics between groups. An age-exact matched sensitivity analysis was additionally reported in the supplementary materials. Kaplan-Meier survival analysis and Fine-Gray competing risk models were used to assess the association between chemotherapy and survival outcomes. A prognostic nomogram based on independent predictors was subsequently constructed to estimate individualized CSD probabilities and was evaluated using internal and external validation cohorts. A total of 216 surgically treated non-metastatic RCNEC patients were identified from SEER, including 111 in the non-chemotherapy group and 105 in the chemotherapy group. After 1:1 PSM, neither overall survival nor cancer-specific survival differed significantly between groups (P = 0.598 and P = 0.422, respectively). In competing-risk analyses, chemotherapy was not associated with a lower cumulative incidence of cancer-specific death (CSD) after matching (P = 0.219), whereas other-cause death remained significantly lower in the chemotherapy group (P = 0.002), a finding likely reflecting treatment selection rather than a protective effect of chemotherapy. The age-exact matched sensitivity analysis yielded consistent findings. In multivariable Fine-Gray analysis, chemotherapy was not independently associated with CSD (sHR = 1.21, P = 0.440). The competing risk-based nomogram showed apparent discrimination, with 1-, 3-, and 5-year AUCs of 0.785, 0.819, and 0.755 in the training cohort, 0.895, 0.856, and 0.864 in the internal validation cohort, and 0.795, 0.891, and 0.897 in the external cohort; however, these estimates should be considered preliminary because the training cohort was modest and the external cohort included only 22 patients. In this SEER-based cohort of surgically treated non-metastatic RCNEC, chemotherapy as recorded in SEER was not independently associated with lower CSD in competing-risk analyses; confirmation in clinically annotated datasets is warranted. Given the limitations of registry-coded chemotherapy data, the absence of association should not be interpreted as lack of efficacy of chemotherapy.

PMID:
42443489
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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