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Reconsideration of Clinicopathologic Prognostic Factors in Pancreatic Neuroendocrine Tumors for Better Determination of Adverse Prognosis.

作者信息

Aysal Anil, Agalar Cihan, Egeli Tufan, Unek Tarkan, Oztop Ilhan, Obuz Funda, Sagol Ozgul

机构信息

Department of Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey.

Department of General Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey.

出版信息

Endocr Pathol. 2021 Dec;32(4):461-472. doi: 10.1007/s12022-021-09687-w. Epub 2021 Jul 20.


DOI:10.1007/s12022-021-09687-w
PMID:34283399
Abstract

The question of how successful we are in predicting pancreatic neuroendocrine tumors (panNET) with poor prognosis has not been fully answered yet. The aim of this study was to investigate the effects of clinicopathological features on prognosis and to determine their validity in prediction of prognosis and whether a better prognostic classification can be made. Fifty-six patients who underwent pancreatic resection for pancreatic neuroendocrine tumor were included. The associations between clinicopathological parameters and prognosis were evaluated statistically. Efficiencies of different thresholds for tumor size, mitotic count, and Ki67 proliferation index for prognosis prediction were compared. Vascular invasion was statistically associated with high tumor grade, advanced pT stage, and mortality rate. The presence of non-functional tumor, lymphatic invasion, and > 10 cm tumor size were significantly related to shorter overall survival. Advanced pT stage (pT3-4), > 5 cm tumor size, and high tumor grade (grades 2-3) were significantly associated with shorter disease-free survival. The mortality rate showed the strongest statistical significance with mitotic count when grouped as 1: < 2, 2: 2-10, and 3: > 10 mitosis/ 2 mm. The 10% threshold value for Ki67 index was more successful in predicting adverse prognosis. Among the morphologic variants, the ductulo-insular variant was the most promising to have positive prognostic value in our series, although no statistical significance was detected. In conclusion, threshold values of 5 cm and 10 cm for tumor size, 10% for Ki67 proliferation index, and 10/2 mm for mitotic count and vascular and lymphatic invasion assessed separately are potential prognostic candidates for better stratification of panNETs.

摘要

相似文献

[1]
Reconsideration of Clinicopathologic Prognostic Factors in Pancreatic Neuroendocrine Tumors for Better Determination of Adverse Prognosis.

Endocr Pathol. 2021-12

[2]
Morphologic Variants of Pancreatic Neuroendocrine Tumors: Clinicopathologic Analysis and Prognostic Stratification.

Endocr Pathol. 2020-9

[3]
Grading of well-differentiated pancreatic neuroendocrine tumors is improved by the inclusion of both Ki67 proliferative index and mitotic rate.

Am J Surg Pathol. 2013-11

[4]
The Impact of Phosphohistone-H3-Assisted Mitotic Count and Ki67 Score in the Determination of Tumor Grade and Prediction of Distant Metastasis in Well-Differentiated Pancreatic Neuroendocrine Tumors.

Endocr Pathol. 2016-6

[5]
The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms.

Am J Surg Pathol. 2015-5

[6]
Prognostic Threshold for Circulating Tumor Cells in Patients With Pancreatic and Midgut Neuroendocrine Tumors.

J Clin Endocrinol Metab. 2021-3-8

[7]
Prognostic features of gastro-entero-pancreatic neuroendocrine neoplasms in primary and metastatic sites: Grade, mesenteric tumour deposits and emerging novelties.

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[8]
Analysis of risk factors for recurrence after curative resection of well-differentiated pancreatic neuroendocrine tumors based on the new grading classification.

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[9]
High-Grade Progression Confers Poor Survival in Pancreatic Neuroendocrine Tumors.

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[10]
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引用本文的文献

[1]
Prognostic Features in Surgically Resected Well-Differentiated Pancreatic Neuroendocrine Tumors: an Analysis of 904 Patients with 7882 Person-Years of Follow-Up.

Endocr Pathol. 2025-6-27

[2]
Well-Differentiated Jejunoileal Neuroendocrine Tumors and Corresponding Liver Metastases: Mesenteric Fibrogenesis and Extramural Vascular Invasion in Tumor Progression.

Cancers (Basel). 2025-4-28

[3]
Subgrading of G2 Pancreatic Neuroendocrine Tumors as 2A (Ki67 3% to < 10%) Versus 2B (10% to ≤ 20%) Identifies Behaviorally Distinct Subsets in Keeping with the Evolving Management Protocols.

Ann Surg Oncol. 2024-10

[4]
Pancreatic Neuroendocrine Microtumors (WHO 2022) Are Not Always Low-Grade Neoplasms: A Case with a Highly Increased Proliferation Rate.

Endocr Pathol. 2024-6

[5]
A Machine Learning Approach Using [F]FDG PET-Based Radiomics for Prediction of Tumor Grade and Prognosis in Pancreatic Neuroendocrine Tumor.

Mol Imaging Biol. 2023-10

[6]
Risk Stratification of Pancreatic Neuroendocrine Neoplasms Based on Clinical, Pathological, and Molecular Characteristics.

J Clin Med. 2022-12-15

[7]
A New Preoperative Scoring System for Predicting Aggressiveness of Non-Functioning Pancreatic Neuroendocrine Neoplasms.

Diagnostics (Basel). 2022-2-3

本文引用的文献

[1]
Morphologic Variants of Pancreatic Neuroendocrine Tumors: Clinicopathologic Analysis and Prognostic Stratification.

Endocr Pathol. 2020-9

[2]
Prognostic and predictive factors on overall survival and surgical outcomes in pancreatic neuroendocrine tumors: recent advances and controversies.

Expert Rev Anticancer Ther. 2019-11-27

[3]
A Clinicopathologic and Molecular Update of Pancreatic Neuroendocrine Neoplasms With a Focus on the New World Health Organization Classification.

Arch Pathol Lab Med. 2019-9-11

[4]
The size of well differentiated pancreatic neuroendocrine tumors correlates with Ki67 proliferative index and is not associated with age.

Dig Liver Dis. 2019-1-22

[5]
Can we predict recurrence in WHO G1-G2 pancreatic neuroendocrine neoplasms? Results from a multi-institutional Spanish study.

Pancreatology. 2019-1-19

[6]
Life expectancy in pancreatic neuroendocrine cancer.

Clin Res Hepatol Gastroenterol. 2018-9-13

[7]
Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67.

Ann Surg Oncol. 2018-5-22

[8]
Gastroenteropancreatic neuroendocrine neoplasms: selected pathology review and molecular updates.

Histopathology. 2018-1

[9]
Vascularity and Tumor Size are Significant Predictors for Recurrence after Resection of a Pancreatic Neuroendocrine Tumor.

Ann Surg Oncol. 2017-3-7

[10]
The Impact of Phosphohistone-H3-Assisted Mitotic Count and Ki67 Score in the Determination of Tumor Grade and Prediction of Distant Metastasis in Well-Differentiated Pancreatic Neuroendocrine Tumors.

Endocr Pathol. 2016-6

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