Teo Roxanne, Goh Brian K P, Tai David W M, Allen John C, Lim Tony K H, Hwang Jacqueline S G, Tan Damien M, Lee Ser-Yee, Chan Chung-Yip, Cheow Peng-Chung, Chow Pierce K H, Ooi London L P J, Chung Alexander Y F, Ong Simon
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Republic of Singapore; School of Medicine, University of Glasgow, Glasgow, Scotland, UK.
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Republic of Singapore; Duke-National University of Singapore Medical School, Singapore, Republic of Singapore.
Surgery. 2017 May;161(5):1235-1245. doi: 10.1016/j.surg.2016.12.001. Epub 2017 Jan 19.
This article aims to validate and compare the performance of 6 prognostication systems-the World Health Organization 2010 grading criteria, the European Neuroendocrine Tumour Society and the American Joint Committee for Cancer staging systems, the Memorial Sloan Kettering Cancer Center staging and grading systems, as well as the Bilimoria criteria in a cohort of patients with pancreatic neuroendocrine neoplasms at a single institution.
A retrospective review of 176 patients with histologically proven pancreatic neuroendocrine neoplasm was performed. The prognostic ability of the various prognostication systems for pancreatic neuroendocrine neoplasm was assessed by analyzing the homogeneity, discriminatory ability, monotonicity of gradient, and Akaike information criteria.
The 5-year overall survival for the 176 patients was 69% and 5-year recurrence-free survival in 119 patients who underwent curative resection was 78%. Comparison between the 6 prognostication systems demonstrated that the World Health Organization 2010 system had the lowest Akaike information criteria score and was hence the best prognostication system in predicting overall survival and recurrence-free survival rates in our cohort of patients. The European Neuroendocrine Tumour Society was superior to the American Joint Committee for Cancer in prognosticating overall survival rates for pancreatic neuroendocrine neoplasms, as there was a statistically significant difference in overall survival across the different stages when stratified by the European Neuroendocrine Tumour Society, while the use of the American Joint Committee for Cancer was limited to distinguishing between patients in stages I and II versus stages III and IV only.
All 6 prognostication systems were useful in the prognostication of pancreatic neuroendocrine neoplasm. The World Health Organization 2010 grading system was the best prognostication system in predicting both overall survival in our entire cohort of patients and recurrence-free survival in the subset of patients who underwent curative resection.
本文旨在验证并比较6种预后评估系统——世界卫生组织2010年分级标准、欧洲神经内分泌肿瘤学会和美国癌症联合委员会分期系统、纪念斯隆凯特琳癌症中心分期和分级系统以及比利莫里亚标准，在单机构的一组胰腺神经内分泌肿瘤患者中的表现。
对176例经组织学证实的胰腺神经内分泌肿瘤患者进行回顾性研究。通过分析同质性、区分能力、梯度单调性和赤池信息准则，评估各种预后评估系统对胰腺神经内分泌肿瘤的预后能力。
176例患者的5年总生存率为69%，119例行根治性切除患者的5年无复发生存率为78%。6种预后评估系统之间的比较表明，世界卫生组织2010年系统的赤池信息准则得分最低，因此是预测我们这组患者总生存率和无复发生存率的最佳预后评估系统。欧洲神经内分泌肿瘤学会在预测胰腺神经内分泌肿瘤总生存率方面优于美国癌症联合委员会，因为根据欧洲神经内分泌肿瘤学会进行分层时，不同分期的总生存率存在统计学显著差异，而美国癌症联合委员会的应用仅限于区分I期和II期患者与III期和IV期患者。
所有6种预后评估系统在胰腺神经内分泌肿瘤的预后评估中均有用。世界卫生组织2010年分级系统是预测我们整个患者队列总生存率以及行根治性切除患者亚组无复发生存率的最佳预后评估系统。
