Metastatic and Locally Advanced Pancreatic Endocrine Carcinomas: Analysis of Factors Associated With Disease Progression

Panzuto, Francesco; Boninsegna, Letizia; Fazio, Nicola; Campana, Davide; Brizzi, Maria Pia; Capurso, Gabriele; Scarpa, Aldo; Braud, Filippo de; Dogliotti, Luigi; Tomassetti, Paola; Fave, Gianfranco Delle; Falconi, Massimo

doi:10.1200/jco.2010.33.0688

Cited by 276 publications

(223 citation statements)

References 17 publications

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“…In addition, selection of patients was based on the requisite of a pathological review and an entire follow-up in our institution since diagnosis. This figure is in the upper range of previous publications using the same restrictive inclusion criteria, which reported a 6-33% frequency of G3 NEN according to ENETS proposals (Pape et al 2008, Niederle et al 2010 Panzuto et al 2011). The highest percentages were observed in two of these series in which untreated or metastatic GEP-NEN patients were enrolled , Panzuto et al 2011.…”

Section: Discussionsupporting

confidence: 58%

“…This figure is in the upper range of previous publications using the same restrictive inclusion criteria, which reported a 6-33% frequency of G3 NEN according to ENETS proposals (Pape et al 2008, Niederle et al 2010 Panzuto et al 2011). The highest percentages were observed in two of these series in which untreated or metastatic GEP-NEN patients were enrolled , Panzuto et al 2011. Interestingly, in four of these publications, the number of G3 ENETS patients was higher than that of PD NEC, suggesting that these two entities do not strictly overlap and do not constitute synonyms (Niederle et al 2010, Jann et al 2011, Panzuto et al 2011.…”

Section: Discussionsupporting

confidence: 57%

“…The highest percentages were observed in two of these series in which untreated or metastatic GEP-NEN patients were enrolled , Panzuto et al 2011. Interestingly, in four of these publications, the number of G3 ENETS patients was higher than that of PD NEC, suggesting that these two entities do not strictly overlap and do not constitute synonyms (Niederle et al 2010, Jann et al 2011, Panzuto et al 2011. Demographic characteristics of G3 GEP and thoracic NEN demonstrate a predominance of male patients.…”

Section: Discussionmentioning

confidence: 87%

“…Recently, in well-differentiated NEN, the prognostic relevance of the proliferation indexes, including the mitotic index and the Ki67 index, has been highlighted, especially in tumors of lung or pancreatic origin (Travis et al 1998, Ekeblad et al 2008, Strosberg et al 2009, Panzuto et al 2011. The importance of proliferation indexes has been formalized and standardized by the European Neuroendocrine Tumor Society (ENETS), with the proposal of an ENETS histological grade for GEP-NEN (Rindi et al 2006(Rindi et al , 2007.…”

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confidence: 99%

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Are G3 ENETS neuroendocrine neoplasms heterogeneous?

Vélayoudom-Céphise

Duvillard²,

Foucan³

et al. 2013

Endocrine-Related Cancer

298

271

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The new WHO classification of gastroenteropancreatic (GEP) neuroendocrine tumors (NET) implies that G3 neoplasms with mitotic index O20 and/or Ki67 index O20% are neuroendocrine carcinomas (NEC), described as poorly differentiated, small or large cell types, by analogy with lung NEC. To characterize the subgroup of non-small-cell-type GEP and thoracic NET with mitotic index O20 and/or Ki67 O20% according to their pathological features, response to cisplatin and overall survival (OS). We reviewed pathological and clinical presentation of G3 non-small-cell-type NET referred to our institution for 5 years. Data from 166 patients with metastatic thoracic and GEP-NET were collected. Twenty-eight patients (17%) fulfill the inclusion criteria. Tumors were classified as well-differentiated NET (G3-WDNET) in 42.8% of cases and poorly differentiated, large-cell NEC (G3-LCNEC) in 57.2% of cases. Plasma chromogranin A or neuron-specific enolase were elevated in 42 and 25% respectively of G3-WDNET and 31 and 50% of G3-LCNEC. Somatostatin receptor scintigraphy was positive in 88 and 50% of G3-WDNET or G3-LCNEC respectively. Complete or partial response to cisplatin was observed in 31% of cases, all classified as G3-LCNEC. The median OS was 41 months for G3-WDNET but 17 months for G3-LCNEC (PZ0.34). Short survival was observed in 25% of G3-WDNET but 62.5% of G3-LCNEC patients (PZ0.049). G3 ENETS GEP and thoracic neuroendocrine neoplasms (NEN) could constitute a heterogeneous subgroup of NEN as regards diagnosis, prognosis, and treatment. If confirmed, future classifications may consider splitting them into two groups according to their morphological differentiation.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

See 2 more Smart Citations

Are G3 ENETS neuroendocrine neoplasms heterogeneous?

Vélayoudom-Céphise

Duvillard²,

Foucan³

et al. 2013

Endocrine-Related Cancer

298

271

View full text Add to dashboard Cite

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“…The genes targeted in PanNETs suggest a personalized approach to treatment [139,140]. Since 16 % of PanNETs harbor mutations in genes involved in PI3K-Akt-mTOR signaling, drugs that target the mTOR pathway should be effective in PanNETs with one of these mutations.…”

Section: Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

The genetic classification of pancreatic neoplasia

2015

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Cancer is caused by the accumulation of inherited and/or acquired alterations in specific genes. The recent decline in the cost of DNA sequencing has allowed tumor sequencing to be conducted on a large scale, which, in turn, has led to an unprecedented understanding of the genetic events that drive neoplasia. This understanding, when integrated with meticulous histologic analyses and with clinical findings, has direct clinical implications. The recent sequencing of all of the major types of cystic and noncystic neoplasms of the pancreas has revealed opportunities for molecular diagnoses and for personalized treatment. This review summarizes the results from these recent studies focusing on the clinical relevance of genomic data.

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