Tumor burden score predicts tumor recurrence of non-functional pancreatic neuroendocrine tumors after curative resection

Ding Hui Dong, Xu Feng Zhang, Alexandra G. Lopez-Aguiar, George Poultsides, Eleftherios Makris, Flavio Rocha, Zaheer Kanji, Sharon Weber, Alexander Fisher, Ryan Fields, Bradley A. Krasnick, Kamran Idrees, Paula M. Smith, Cliff Cho, Megan Beems, Carl R. Schmidt, Mary Dillhoff, Shishir K. Maithel, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: To investigate the feasibility of Tumor Burden Score (TBS) to predict tumor recurrence following curative-intent resection of non-functional pancreatic neuroendocrine tumors (NF-pNETs). Method: The TBS cut-off values were determined by a statistical tool, X-tile. The influence of TBS on recurrence-free survival (RFS) was examined. Results: Among 842 NF-pNETs patients, there was an incremental worsening of RFS as the TBS increased (5-year RFS, low, medium, and high TBS: 92.0%, 73.3%, and 59.3%, respectively; P < 0.001). TBS (AUC 0.74) out-performed both maximum tumor size (AUC 0.65) and number of tumors (AUC 0.5) to predict RFS (TBS vs. maximum tumor size, p = 0.05; TBS vs. number of tumors, p < 0.01). The impact of margin (low TBS: R0 80.4% vs. R1 71.9%, p = 0.01 vs. medium TBS: R0 55.8% vs. R1 37.5%, p = 0.67 vs. high TBS: R0 31.9% vs. R1 12.0%, p = 0.11) and nodal (5-year RFS, low TBS: N0 94.9% vs. N1 68.4%, p < 0.01 vs. medium TBS: N0 81.8% vs. N1 55.4%, p < 0.01 vs. high TBS: N0 58.0% vs. N1 54.2%, p = 0.15) status on 5-year RFS outcomes disappeared among patients who had higher TBS. Conclusions: TBS was strongly associated with risk of recurrence and outperformed both tumor size and number alone.

Original languageEnglish (US)
Pages (from-to)1149-1157
Number of pages9
JournalHPB
Volume22
Issue number8
DOIs
StatePublished - Aug 2020
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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