Clinical outcomes and prognostic factors of resected pancreatic neuroendocrine neoplasms: A single-center experience in China

Jin, Kaizhou; Luo, Guopei; Xu, Jin; Zhang, B. O.; Liu, Chen; Ji, Shunrong; Liu, Liang; Jiang, Long; Ni, Quanxing; Lei, Yu

doi:10.3892/ol.2017.5834

Cited by 16 publications

(12 citation statements)

References 25 publications

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“…In clinical practice, grade 2 NETs form a very heterogeneous group and survival in this group can be very different between a "low" grade 2 with a Ki67 close to 2% or a "high" grade 2 with a Ki67 close to 20%. In our study, a cut off of 5% turned out to be more relevant than a cut off of 2% for Ki67, which has already been suggested (3,6,23). The WHO classification of NET should therefore probably be revised.…”

Section: Discussionmentioning

confidence: 58%

“…Survival and prognostic factors analysis of 151 intestinal and pancreatic neuroendocrine tumors: a single center experience Tumor grade, stage, degree of differentiation, and primary tumor size, are well recognized as prognostic factors in NETs. Other factors related to poorer prognosis have been suggested like advanced age at diagnosis, pancreatic tumor localization, the presence of synchronous metastases, and functional character of the tumor, but are still discussed (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Tumor grade, evaluated according to the 2006 ENETS classification based on two proliferative markers [mitotic index (MI) and Ki67 labeling index], is considered the major prognostic factor.…”

Section: Original Articlementioning

confidence: 99%

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Survival and prognostic factors analysis of 151 intestinal and pancreatic neuroendocrine tumors: a single center experience

Foubert

Salimon

Dumars

et al. 2018

J. Gastrointest. Oncol

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Background: Intestinal and pancreatic neuroendocrine tumors (IP-NETs) are rare tumors with heterogeneous outcomes. The aim of our study was to determine the clinical, therapeutic and pathological factors which impact the overall survival (OS) in IP-NETs. Methods: All the patients diagnosed with IP-NETs at the Nantes University Hospital between October 1994 and October 2013 were retrospectively analysed. Patients with MEN-1 (Type 1 Multiple Endocrine Neoplasia) or Von Hippel-Lindau syndrome were excluded. Additionally, a prospective analysis of tumor grade (mitotic index and Ki67 index) was performed on tumor samples. OS was evaluated by Kaplan-Meier method and prognostic factors by log-rank test and Cox model. Results: The study included 151 patients. Median age was 60 (range, 14-81). Primary tumor was pancreatic in 86 patients (56.95%) and intestinal in 65 patients (43.05%). Tumors were metastatic (synchronous or metachronous) in 72 patients (47.7%). The median OS was 157 months. For all IP-NETs, age >65 years (P<0.0001), Ki67 >5% (P=0.03), synchronous metastases (P=0.016), primary tumor size >25 mm (P=0.03) and emergency surgery (P=0.007) were independent poor prognostic factors. Conclusions: In this large series of patients with IP-NET, age >65 years, Ki67 >5%, primary tumor size >25 mm, synchronous metastases and emergency surgery for acute complications have been identified as independent poor prognostic factors.

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Section: Discussionmentioning

confidence: 58%

Section: Original Articlementioning

confidence: 99%

Survival and prognostic factors analysis of 151 intestinal and pancreatic neuroendocrine tumors: a single center experience

Foubert

Salimon

Dumars

et al. 2018

J. Gastrointest. Oncol

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“…However, whether it is an prognostic factor has always been conflicting, as different investigations giving different results14 . A number of studies reported that lymph node status had important prognostic value9,23,24,25,26. However, other reports failed to detect a survival difference in those with lymph node diseases27,28,29.…”

Section: Discussionmentioning

confidence: 99%

“…Tumour size is a readily available parameter, can be accurately measured and has the great advantage of little discrepancy among observers. Its prognostic value in PNETs has been investigated extensively 8,9,10,30,31,32,33. Although the results beween different studies were inconsistent, tumour size was used as a criterion of staging in the AJCC and ENETS system6,7.…”

Section: Discussionmentioning

confidence: 99%

“…The proposed American Joint Committee on Cancer (AJCC) and European Neuroendocrine Tumours Society (ENETS) classifications have defined disease stage based on size of primary tumour6,7. However, validation of these systems has been conflicting, and tumour size has not been shown to be significantly predictive of survival in several studies8,9,10. Even more, Kuo and his colleagues reported a relatively high rate of metastasis in small tumours11.…”

Section: Introductionmentioning

confidence: 99%

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Impact of tumour size on metastasis and survival in patients with pancreatic neuroendocrine tumours (PNETs): A population based study

Liu

Zhu

et al. 2019

J. Cancer

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Background: The relationship between tumour size and metastasis rate is poorly recognized in patients with pancreatic neuroendocrine tumours (PNETs). The impact of tumour size on prognosis was controversial in previous investigations.Methods: PNETs cases diagnosed from 1988 to 2013 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Clinicopathologic features were retrospectively analyzed. Survival was calculated by the Kaplan-Meier method. Multivariable Cox regression models with hazard ratios (HRs) were constructed to analyze survival outcomes and risk factors. Cubic spline analysis was used to assess relationship between tumor size and probability of metastasis.Results: A total of 5424 patients were identified, 1226 (22.6%) with tumour size of 20mm or less. The probability of metastasis increased in a non-linear fashion with increasing tumour size. Univariate analysis showed that tumour size was significantly correlated with survival (P<0.001), no matter surgery was performed or not. However, subgroup analysis suggested this association to be linear for patients with localized and regional tumours (P<0.001), but stochastic in patients with distant stages (P=0.703). On multivariate analysis, tumour size was an indicator for metastasis (HR=1.010, 95%CI: 1.008-1.013, P<0.001) and size≤20mm was an independent prognostic factor for good survival. For tumours≤20mm, surgical treatment was associated with significantly improved survival (P<0.001).Conclusions: Tumour size affects the probability of metastasis. Its prognostic impact on survival is restricted to patients with localized and regional disease. For patients with tumour size ≤20mm, surgical treatment should be considered preferably.

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Prognostic predictors for recurrence following curative resection in grade I/II pancreatic neuroendocrine tumours

Chopde

Gupta²,

Chaudhari

et al. 2023

Langenbecks Arch Surg

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Clinical outcomes and prognostic factors of resected pancreatic neuroendocrine neoplasms: A single-center experience in China

Abstract: Abstract. The aim of the present study was to investigate the clinical, pathological and prognostic characteristics of Chinese patients with resected pancreatic neuroendocrine neoplasms (p-NENs). Data from patients who were surgically treated and pathologically diagnosed with p-NENs at the

Cited by 16 publications

References 25 publications

Survival and prognostic factors analysis of 151 intestinal and pancreatic neuroendocrine tumors: a single center experience

Survival and prognostic factors analysis of 151 intestinal and pancreatic neuroendocrine tumors: a single center experience

Impact of tumour size on metastasis and survival in patients with pancreatic neuroendocrine tumours (PNETs): A population based study

Prognostic predictors for recurrence following curative resection in grade I/II pancreatic neuroendocrine tumours

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