美国癌症联合委员会第八版分期系统对高分化胰腺神经内分泌肿瘤的预后有效性

Prognostic validity of the American joint committee on cancer eighth edition staging system for well-differentiated pancreatic neuroendocrine tumors.

作者信息

Wang Hebin, Ding Ding, Qin Tingting, Zhang Hang, Liu Jun, Zhao Junfang, Wu Chien-Hui, Javed Ammar, Wolfgang Christopher, Guo Shiwei, Chen Qingmin, Zhao Weihong, Shi Wei, Zhu Feng, Guo Xingjun, Li Xu, Peng Feng, He Ruizhi, Xu Simiao, Jin Jikuan, Wu Yi, Nuer Abula, Edil Barish, Tien Yu-Wen, Jin Gang, Zheng Lei, He Jin, Liu Jianhua, Liu Yahui, Wang Min, Qin Renyi

机构信息

Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.

Departments of Surgery and Oncology, The Pancreatic Cancer Precision Medicine Center of Excellence Program, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

出版信息

HPB (Oxford). 2022 May;24(5):681-690. doi: 10.1016/j.hpb.2021.10.017. Epub 2021 Nov 2.

DOI:10.1016/j.hpb.2021.10.017

PMID:34836754

Abstract

BACKGROUND

The American Joint Committee on Cancer (AJCC) made improvements for staging pancreatic neuroendocrine tumors (pNETs) in its 8th Edition; however, multicenter studies were not included.

METHODS

We collected multicenter datasets (n = 1,086, between 2004 and 2018) to validate the value of AJCC 8 and other coexisting staging systems through univariate and multivariate analysis for well-differentiated (G1/G2) pNETs.

RESULTS

Compared to other coexisting staging systems, AJCC 7 only included 12 (1.1%) patients with stage III tumors. Patients with European Neuroendocrine Tumor Society (ENETS) stage IIB disease had a higher risk of death than patients with stage IIIA (hazard ratio [HR]: 4.376 vs. 4.322). For the modified ENETS staging system, patients with stage IIB disease had a higher risk of death than patients with stage III (HR: 6.078 vs. 5.341). According to AJCC 8, the proportions of patients with stage I, II, III, and IV were 25.7%, 40.3%, 23.6%, and 10.4%, respectively. As the stage advanced, the median survival time decreased (NA, 144.7, 100.8, 72.0 months, respectively), and the risk of death increased (HR: II = 3.145, III = 5.925, and IV = 8.762).

CONCLUSION

These findings suggest that AJCC 8 had a more reasonable proportional distribution and the risk of death was better correlated with disease stage.

摘要

背景

美国癌症联合委员会（AJCC）在其第8版中对胰腺神经内分泌肿瘤（pNETs）的分期进行了改进；然而，未纳入多中心研究。

方法

我们收集了多中心数据集（2004年至2018年间，n = 1086），通过单因素和多因素分析来验证AJCC第8版及其他并存分期系统对高分化（G1/G2）pNETs的价值。

结果

与其他并存分期系统相比，AJCC第7版仅纳入了12例（1.1%）III期肿瘤患者。欧洲神经内分泌肿瘤学会（ENETS）IIB期疾病患者的死亡风险高于IIIA期患者（风险比[HR]：4.376对4.322）。对于改良的ENETS分期系统，IIB期疾病患者的死亡风险高于III期患者（HR：6.078对5.341）。根据AJCC第8版，I期、II期、III期和IV期患者的比例分别为25.7%、40.3%、23.6%和10.4%。随着分期进展，中位生存时间缩短（分别为无数据、144.7、100.8、72.0个月），死亡风险增加（HR：II期 = 3.145，III期 = 5.925，IV期 = 8.762）。