TY - JOUR
T1 - Pancreatic grade 3 neuroendocrine tumors behave similarly to neuroendocrine carcinomas following resection
T2 - a multi-center, international appraisal of the WHO 2010 and WHO 2017 staging schema for pancreatic neuroendocrine lesions
AU - The International Pancreatic Neuroendocrine Tumor Study Group
AU - Worth, Patrick J.
AU - Leal, Julie
AU - Ding, Qian
AU - Trickey, Amber
AU - Dua, Monica M.
AU - Chatzizacharias, Nikolaos
AU - Soonawalla, Zahir
AU - Athanasopoulos, Panagiotis
AU - Toumpanakis, Christos
AU - Hansen, Paul
AU - Parks, Rowan W.
AU - Connor, Saxon
AU - Parker, Kate
AU - Koea, Jonathan
AU - Srinavasa, Sanket
AU - Ielpo, Benedetto
AU - Vicente Lopez, Emilio
AU - Lawrence, Benjamin
AU - Visser, Brendan C.
N1 - Publisher Copyright:
© 2020 International Hepato-Pancreato-Biliary Association Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - Background: In 2017, the WHO updated their 2010 classification of pancreatic neuroendocrine tumors, introducing a well-differentiated, highly proliferative grade 3 tumor, distinct from neuroendocrine carcinomas. The aim of this study was to investigate the clinical significance of this update in a large cohort of resected tumors. Methods: Using a multicenter, international dataset of patients with pancreatic neuroendocrine lesions, patients were classified both according to the WHO 2010 and 2017 schema. Multivariable survival analyses were performed, and the models were evaluated for discrimination ability and goodness of fit. Results: Excluding patients with a known germline MEN1 mutation and incomplete data, 544 patients were analyzed. The performance of the WHO 2010 and 2017 models was similar, however surgically resected grade 3 tumors behaved very similarly to neuroendocrine carcinomas. Conclusion: The addition of a grade 3 NET classification may be of limited utility in surgically resected patients, as these lesions have similar postoperative survival compared to carcinomas. While the addition may allow for a more granular evaluation of novel treatment strategies, surgical intervention for high grade tumors should be considered judiciously.
AB - Background: In 2017, the WHO updated their 2010 classification of pancreatic neuroendocrine tumors, introducing a well-differentiated, highly proliferative grade 3 tumor, distinct from neuroendocrine carcinomas. The aim of this study was to investigate the clinical significance of this update in a large cohort of resected tumors. Methods: Using a multicenter, international dataset of patients with pancreatic neuroendocrine lesions, patients were classified both according to the WHO 2010 and 2017 schema. Multivariable survival analyses were performed, and the models were evaluated for discrimination ability and goodness of fit. Results: Excluding patients with a known germline MEN1 mutation and incomplete data, 544 patients were analyzed. The performance of the WHO 2010 and 2017 models was similar, however surgically resected grade 3 tumors behaved very similarly to neuroendocrine carcinomas. Conclusion: The addition of a grade 3 NET classification may be of limited utility in surgically resected patients, as these lesions have similar postoperative survival compared to carcinomas. While the addition may allow for a more granular evaluation of novel treatment strategies, surgical intervention for high grade tumors should be considered judiciously.
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U2 - 10.1016/j.hpb.2019.12.014
DO - 10.1016/j.hpb.2019.12.014
M3 - Article
C2 - 32081540
AN - SCOPUS:85079543731
SN - 1365-182X
VL - 22
SP - 1359
EP - 1367
JO - HPB
JF - HPB
IS - 9
ER -