Value of Both WHO and TNM Classification Systems for Patients with Pancreatic Endocrine Tumors: Results of a Single‐Center Series

Casadei, Riccardo; Ricci, Claudio; Pezzilli, Raffaele; Campana, Davide; Tomassetti, Paola; Calculli, Lucia; Santini, Donatella; Antonacci, Nicola; Minni, Francesco

doi:10.1007/s00268-009-0182-4

Cited by 20 publications

(12 citation statements)

References 31 publications

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“…The present study documented that higher grade PNETs exhibited greater recurrence than PNETs of a lower grade (P<0.001). The most important factors to affect OS and DFS rates were stage and grade, as observed previously in a number of studies (2,6,9,13). Greater recurrence was predicted in association with regional disease rather than local disease.…”

Section: Discussionsupporting

confidence: 61%

“…Several studies reported that the main factors predicting survival after the resection of PNETs were the tumor grade, the presenting symptoms, the size of the lesion, lymph node involvement and the presence of metastases (4,9–14). To evaluate the experience of a single institution with regard to these uncommon tumors, a retrospective review of 104 consecutive resections of PNETs was conducted in the present study in order to analyze clinical characteristics, to assess long-term survival following surgical treatment, and to discuss the prognosis of affected patients.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors of long-term outcome in surgically resectable pancreatic neuroendocrine tumors: A 12-year experience from a single center

et al. 2017

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The present study was performed to assess the prognostic factors with respect to patient survival and clinicopathological characteristics for patients who underwent surgery for pancreatic neuroendocrine tumors (PNETs). A retrospective review of patients pathologically diagnosed with PNETs at the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, Zhejiang, China) between September 2002 and September 2013 was conducted. The clinicopathological findings, overall survival (OS) rate and disease-free survival (DFS) rate of the patients with PNETs were analyzed. Prognostic factors were determined by univariate and multivariate analyses. A total of 104 patients were selected. The median age at presentation was 52 years (range, 19–76 years). The most common surgical procedure was distal pancreatectomy (51.0%), followed by pancreaticoduodenectomy (27.9%) and local resection of the pancreas (16.3%). The majority of the tumors were of low or moderate grade (93.3%, grade 1 or 2) and were local or regional stage (92.3%). The 1-, 3- and 5-year OS rates were 95, 85 and 73%, respectively. Meanwhile, the 1-, 3- and 5-year DFS rates were 86, 72 and 68%, respectively. The OS and DFS rates were significantly different with regard to the grade (grades 1, 2 and 3; P<0.001) and stage (local, regional and distant disease; P<0.001). Furthermore, patients with a low Ki-67 index experienced superior OS and DFS rates compared with patients with a high Ki-67 index (P<0.001). The presence of lymph node metastasis was predictive of inferior OS and DFS rates compared with the absence of lymph node metastasis (P<0.001). OS rate for PNETs was significantly affected by resection margin status (P<0.001). In multivariable analysis, the significant factors associated with OS rate were stage (P=0.02), grade (P<0.001), lymph node status (P=0.025), Ki-67 index (P=0.031) and resection margin status (P<0.001). Meanwhile, stage (P=0.001), grade (P=0.017), lymph node status (P=0.02) and Ki-67 index (P=0.016) were prognostic factors for DFS rate. In conclusion, grade, stage, Ki-67 index and lymph node involvement are significant prognostic factors for OS and DFS rates in surgically resectable PNETs. Furthermore, surgical margin status may also be an independent predictor for the prognosis of PNETs. It is anticipated that these findings may provide useful predictors of clinical survival, particularly in the setting of resected disease.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Prognostic factors of long-term outcome in surgically resectable pancreatic neuroendocrine tumors: A 12-year experience from a single center

et al. 2017

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“…Determination of mitotic index by counting 10 HPF and/or calculation of Ki67 index by immunohistochemistry are mandatory as is assessment of the degree of invasion [5,8,131]. Recently, for p-NETs, WHO and ENETS TNM classification systems with grading have been proposed and numerous studies have validated their prognostic significance; therefore, it is important p-NETs be appropriate classified by these systems [21,24,25,29,30,48,133,134,135,136]. …”

Section: Histopathology and Genetics Of Functional P-nets [581517mentioning

confidence: 99%

ENETS Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Neoplasms: Functional Pancreatic Endocrine Tumor Syndromes

Jensen¹,

et al. 2012

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“…However, it is well known that PETs are rather slow-growing tumors and they have a biological behavior less aggressive than pancreatic adenocarcinoma [1] with a 5-year survival ranging from 59.3% [12] to 79.5% [8]. Surgical R0 resection is the only potential curative treatment for patients affected by PETs.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to Long-Term Survival in Patients Affected by Well-Differentiated Endocrine Tumors of the Pancreas

et al. 2012

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Aim. To identify factors related to survival in patients affected by well-differentiated PETs (benign, uncertain behavior, and carcinoma) who underwent R0 pancreatic resection. Methods. Retrospective study of 74 consecutive patients followed up from January 1980 to December 2011. Prognostic factors were sex, age, type of tumor, presence of symptoms, type of surgical procedure, size of tumor, lymph nodes status, WHO classification, and TNM stage. Overall survival was evaluated using the Kaplan-Meier method. Cox regression analyses were used to identify the factors associated with prognosis in univariate and multivariate analysis. Results. The mean follow-up of all the patients was 106 ± 89 months. The 5–10-year long-term survival was 90.9% and 79.1%, respectively. At univariate analysis, patient age <55 years was significantly related to a better long-term survival compared to patients age ≥55 years (307 ± 15 months versus 192 ± 25 months; P = 0.010). Multivariate analysis showed that female gender (P = 0.006), patients without comorbidities (P = 0.033), and patients affected by well-differentiated benign pancreatic endocrine tumors (P = 0.008 and P = 0.002 in relation to tumors with uncertain behavior and carcinomas, resp.) were factors significantly related to a better long-term survival. Conclusions. Patients factors were strongly related to a better long-term survival in patients observed. WHO classification is a very useful prognostic tool for well-differentiated PETs.

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Value of Both WHO and TNM Classification Systems for Patients with Pancreatic Endocrine Tumors: Results of a Single‐Center Series

Abstract: TNM stage and the WHO classification seems to be equally reliable, even if TNM classification tends to understage the patients classified using the WHO system.

Cited by 20 publications

References 31 publications

Prognostic factors of long-term outcome in surgically resectable pancreatic neuroendocrine tumors: A 12-year experience from a single center

Prognostic factors of long-term outcome in surgically resectable pancreatic neuroendocrine tumors: A 12-year experience from a single center

ENETS Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Neoplasms: Functional Pancreatic Endocrine Tumor Syndromes

Factors Related to Long-Term Survival in Patients Affected by Well-Differentiated Endocrine Tumors of the Pancreas

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