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TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution.

Yang M, Zeng L, Zhang Y, Wang WG, Wang L, Ke NW, Liu XB, Tian BL - Medicine (Baltimore) (2015)

Bottom Line: Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05).Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144).What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Hepatobiliopancreatic Surgery (MY, YZ, W-gW, LW, N-wK, X-bL, B-lT); and General Ward of Sports Medicine and Cardiopulmonary Rehabilitation (LZ), West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT
We aimed to analyze the clinical characteristics and compare the surgical outcome of pancreatic neuroendocrine tumors (p-NETs) using the 2 tumor-node-metastasis (TNM) systems by both the American Joint Committee on Cancer (AJCC) Staging Manual (seventh edition) and the European Neuroendocrine Tumor Society (ENETS). Moreover, we sought to validate the prognostic value of the new AJCC criterion. Data of 145 consecutive patients who were all surgically treated and histologically diagnosed as p-NETs from January 2002 to June 2013 in our single institution were retrospectively collected and analyzed. The 5-year overall survival (OS) rates for AJCC classifications of stages I, II, III, and IV were 79.5%, 63.1%, 15.0%, and NA, respectively, (P < 0.005). As for the ENETS system, the OS rates at 5 years for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA, respectively, (P < 0.005). Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05). Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144). What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively). Our study indicated that the ENETS TNM staging system might be superior to the AJCC Staging Manual (seventh edition) for the clinical practice of p-NETs. Together with tumor grade and radical resection, the new AJCC system was also validated to be an independent predictor for p-NETs.

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Related in: MedlinePlus

Survivals for p-NETs in different stages by the ENETS classification. Differences between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively). Meanwhile, there was no statistically obvious difference between stage I and stage II (P = 0.207), whereas notable difference was detected between stages III and IV (P = 0.031). ENETS = European Neuroendocrine Tumor Society, p-NETs = pancreatic neuroendocrine tumor.
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Figure 2: Survivals for p-NETs in different stages by the ENETS classification. Differences between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively). Meanwhile, there was no statistically obvious difference between stage I and stage II (P = 0.207), whereas notable difference was detected between stages III and IV (P = 0.031). ENETS = European Neuroendocrine Tumor Society, p-NETs = pancreatic neuroendocrine tumor.

Mentions: As for the ENETS system, the 5-year OS rates for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA (could not be calculated), respectively (P < 0.005, Figure 2); the MST for each stage was NA, 83.4, 43.4, and 18.2 months, respectively. Differences of survival between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively), whereas no obvious difference was detected between those of stage I and stage II (P = 0.207). However, there was statistically notable difference between the survival rates of stage III and IV (P = 0.031).


TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution.

Yang M, Zeng L, Zhang Y, Wang WG, Wang L, Ke NW, Liu XB, Tian BL - Medicine (Baltimore) (2015)

Survivals for p-NETs in different stages by the ENETS classification. Differences between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively). Meanwhile, there was no statistically obvious difference between stage I and stage II (P = 0.207), whereas notable difference was detected between stages III and IV (P = 0.031). ENETS = European Neuroendocrine Tumor Society, p-NETs = pancreatic neuroendocrine tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554009&req=5

Figure 2: Survivals for p-NETs in different stages by the ENETS classification. Differences between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively). Meanwhile, there was no statistically obvious difference between stage I and stage II (P = 0.207), whereas notable difference was detected between stages III and IV (P = 0.031). ENETS = European Neuroendocrine Tumor Society, p-NETs = pancreatic neuroendocrine tumor.
Mentions: As for the ENETS system, the 5-year OS rates for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA (could not be calculated), respectively (P < 0.005, Figure 2); the MST for each stage was NA, 83.4, 43.4, and 18.2 months, respectively. Differences of survival between stage I and stages III and IV were statistically significant (P = 0.001 and P < 0.005, respectively), as well as those between stage II and stages III and IV (P = 0.009 and P < 0.005, respectively), whereas no obvious difference was detected between those of stage I and stage II (P = 0.207). However, there was statistically notable difference between the survival rates of stage III and IV (P = 0.031).

Bottom Line: Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05).Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144).What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Hepatobiliopancreatic Surgery (MY, YZ, W-gW, LW, N-wK, X-bL, B-lT); and General Ward of Sports Medicine and Cardiopulmonary Rehabilitation (LZ), West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT
We aimed to analyze the clinical characteristics and compare the surgical outcome of pancreatic neuroendocrine tumors (p-NETs) using the 2 tumor-node-metastasis (TNM) systems by both the American Joint Committee on Cancer (AJCC) Staging Manual (seventh edition) and the European Neuroendocrine Tumor Society (ENETS). Moreover, we sought to validate the prognostic value of the new AJCC criterion. Data of 145 consecutive patients who were all surgically treated and histologically diagnosed as p-NETs from January 2002 to June 2013 in our single institution were retrospectively collected and analyzed. The 5-year overall survival (OS) rates for AJCC classifications of stages I, II, III, and IV were 79.5%, 63.1%, 15.0%, and NA, respectively, (P < 0.005). As for the ENETS system, the OS rates at 5 years for stages I, II, III, and IV were 75.5%, 72.7%, 29.0%, and NA, respectively, (P < 0.005). Both criteria present no statistically notable difference between stage I and stage II (P > 0.05) but between stage I and stages III and IV (P < 0.05), as well as those between stage II and stages III and IV (P < 0.05). Difference between stage III and IV by ENETS was significant (P = 0.031), whereas that by the AJCC was not (P = 0.144). What's more, the AJCC Staging Manual (seventh edition) was statistically significant in both uni- and multivariate analyses by Cox regression (P < 0.005 and P = 0.025, respectively). Our study indicated that the ENETS TNM staging system might be superior to the AJCC Staging Manual (seventh edition) for the clinical practice of p-NETs. Together with tumor grade and radical resection, the new AJCC system was also validated to be an independent predictor for p-NETs.

Show MeSH
Related in: MedlinePlus