Comparison of the prognostic values of the 2010 WHO classification, AJCC 7th edition, and ENETS classification of gastric neuroendocrine tumors

Kim, Beom Su; Park, Young Soo; Yook, Jeong Hwan; Kim, Byung-Sik

doi:10.1097/md.0000000000003977

Cited by 23 publications

(17 citation statements)

References 22 publications

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“…Pattern and risk factors for distant metastases in gastrointestinal neuroendocrine neoplasms: a populationbased study neuroendocrine carcinoma (NEC) based on the morphology and proliferation rate [4,5]. It is generally acknowledged that survival is better for NET than for NEC.…”

Section: Original Researchmentioning

confidence: 99%

“…The most recent 2010 WHO system has defined all neuroendocrine tumors (NETs) as neoplasms with malignant potential, and the acronym NEN is recommended to corresponding to the term neuroendocrine neoplasia. NENs are currently classified as either well‐differentiated (low‐grade to intermediate‐grade) neuroendocrine tumors (NET) or poorly differentiated (high‐grade) neuroendocrine carcinoma (NEC) based on the morphology and proliferation rate . It is generally acknowledged that survival is better for NET than for NEC.…”

Section: Introductionmentioning

confidence: 99%

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Pattern and risk factors for distant metastases in gastrointestinal neuroendocrine neoplasms: a population‐based study

Cui

Tan

et al. 2018

Cancer Medicine

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An increased incidence of gastrointestinal neuroendocrine neoplasms (GI‐NENs) has been reported worldwide, and metastasis is the leading cause of GI‐NEN‐related death. Studies of different metastatic patterns in patients with different primary sites are limited. A population‐based retrospective cohort study was conducted with the Surveillance, Epidemiology, and End Results (SEER) database. Patients with a GI‐NEN diagnosis between 2010 and 2014 were included. All statistical analyses were performed using Intercooled Stata 12.0 software. There were 12,501 patients eligible for analysis. The metastatic status, primary sites, and histology types affected the patients’ overall survival. The liver was the most common metastasis site (65.21% of patients with metastases). Esophageal NENs had the highest risk of metastasis (49.35%), whereas appendiceal NENs had the lowest risk of metastasis (2.79%). Neuroendocrine carcinomas (NECs) were more likely to develop metastatic disease than were neuroendocrine tumors (NETs); 7.12% of patients with NET and 30.20% of patients with NEC developed metastatic disease. The metastatic patterns varied according to the different primary sites and histology types. NECs had a higher potential to develop extrahepatic metastasis at all primary sites than did NETs. Regarding the choice of treatment, surgical resection of primary lesions lowered the risk of tumor‐specific death (HR = 0.37, CI: 0.30–0.46, P < 0.01), but surgical resection of metastatic sites did not confer an extra survival benefit (HR = 0.82, CI: 0.63–1.06, P = 0.14). Different primary sites and histology types of GI‐NENs have different metastatic patterns and survival. This knowledge could help clinicians to identify patients who require extra surveillance, provide insight for future studies on the mechanisms of metastasis, and establish a prognostic prediction model.

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Section: Original Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pattern and risk factors for distant metastases in gastrointestinal neuroendocrine neoplasms: a population‐based study

Cui

Tan

et al. 2018

Cancer Medicine

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“…For the risk stratification of GC, the TNM Staging System has been widely used, which is developed and maintained by American Joint Committee on Cancer (AJCC) and adopted by the Union International Committee on Cancer (UICC). Although TNM staging system is of great value clinically, it has not adequate prognostic and predictive capabilities to guide patient management 5 , 6 . Thus, new biomarkers are needed to discriminate the high-risk patients with GC and consequently improve personalized cancer care.…”

Section: Introductionmentioning

confidence: 99%

Differentially Expressed lncRNAs in Gastric Cancer Patients: A Potential Biomarker for Gastric Cancer Prognosis

Tian¹,

Zhu²,

Yan³

et al. 2017

J. Cancer

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Current studies indicate that long non-coding RNAs (lncRNAs) are frequently aberrantly expressed in cancers and implicated with prognosis in gastric cancer (GC). We intended to generate a multi-lncRNA signature to improve prognostic prediction of GC. By analyzing ten paired GC and adjacent normal mucosa tissues, 339 differentially expressed lncRNAs were identified as the candidate prognostic biomarkers in GC. Then we used LASSO Cox regression method to build a 12-lncRNA signature and validated it in another independent GEO dataset. An innovative 12-lncRNA signature was established, and it was significantly associated with the disease free survival (DFS) in the training dataset. By applying the 12-lncRNA signature, the training cohort patients could be categorized into high-risk or low-risk subgroup with significantly different DFS (HR = 4.52, 95%CI= 2.49-8.20, P < 0.0001). Similar results were obtained in another independent GEO dataset (HR=1.58, 95%CI=1.05 - 2.38, P=0.0270). Further analysis showed that the prognostic value of this 12-lncRNA signature was independent of AJCC stage and postoperative chemotherapy. Receiver operating characteristic (ROC) analysis showed that the area under receiver operating characteristic curve (AUC) of combined model reached 0.869. Additionally, a well-performed nomogram was constructed for clinicians. Moreover, single-sample gene-set enrichment analysis (ssGSEA) showed that a group of pathways related to drug resistance and cancer metastasis significantly enriched in the high risk patients. A useful innovative 12-lncRNA signature was established for prognostic evaluation of GC. It might complement clinicopathological features and facilitate personalized management of GC.

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“…Most of the previous cases were diagnosed by gross specimens from surgery, such as gastrectomy. In 2010, the WHO named mixed adenoneuroendocrine carcinomas (MANECs), which present neuroendocrine cells (usually over 30% of all tumor cells) mixed with nonendocrine components (usually adenocarcinoma) ( 4 ), as a new category in the list of NECs. Interestingly, some of the previous cases are likely to be reclassified into this group retrospectively.…”

Section: Introductionmentioning

confidence: 99%

Gastric adenocarcinoma is concurrent with metastatic neuroendocrine cancer treated with nivolumab and chemotherapy: A case report

et al. 2018

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Gastric adenocarcinoma concurrent with metastatic neuroendocrine cancer (NEC) is rare. In the present case report, a 39-year-old male was first pathologically diagnosed by gastric endoscopy as having a highly differentiated adenocarcinoma. Next, positron emission tomography-computed tomography examination and bone marrow biopsy confirmed extensive metastasis. Subsequently, the patient underwent 6 cycles of immunotherapy (nivolumab, 160 mg) and 5 cycles of chemotherapy based on the XELOX regimen (oxaliplatin + capecitabine). Following this, the patient received the final cycles of nivolumab and XELOX; however, the patient then succumbed. Further biopsy of the metastatic collarbone lymph nodes indicated NEC. Overall, the progression-free survival was ~3.5 months, and overall survival (OS) was ~6 months. The case presented the possibility of concurrent gastric adenocarcinoma and NEC in the clinic. In addition, the efficacy of a combined regimen such as immunotherapy and chemotherapy for such disorders still requires further validation in the future.

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Comparison of the prognostic values of the 2010 WHO classification, AJCC 7th edition, and ENETS classification of gastric neuroendocrine tumors

Cited by 23 publications

References 22 publications

Pattern and risk factors for distant metastases in gastrointestinal neuroendocrine neoplasms: a population‐based study

Pattern and risk factors for distant metastases in gastrointestinal neuroendocrine neoplasms: a population‐based study

Differentially Expressed lncRNAs in Gastric Cancer Patients: A Potential Biomarker for Gastric Cancer Prognosis

Gastric adenocarcinoma is concurrent with metastatic neuroendocrine cancer treated with nivolumab and chemotherapy: A case report

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