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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 with different resections. Patients undergoing radical resections present a statistically better survival than those who only underwent palliative or explorative operations (P < 0.005). p-NETs = pancreatic neuroendocrine tumor.
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Figure 4: Survivals for p-NETs with different resections. Patients undergoing radical resections present a statistically better survival than those who only underwent palliative or explorative operations (P < 0.005). p-NETs = pancreatic neuroendocrine tumor.

Mentions: All patients in this study received surgical treatments so that the diagnosis of p-NETs could be histologically confirmed from the resected tissues or biopsies. There were totally 128 patients undergoing radical resections (88%), including local resection of pancreatic tumor (40.0%), distal pancreatectomy (24.8%), pancreaticoduodenectomy (11.2%), and others (12.0%), whereas palliative or explorative operations were performed only on 17 patients (12.0%). With an MST of 88.3 and 18.4 months, respectively, patients undergoing radical resections present a statistically better survival than those who did not (OS at 5 years were 67.1% and NA, respectively) (P < 0.005, Figure 4).


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 with different resections. Patients undergoing radical resections present a statistically better survival than those who only underwent palliative or explorative operations (P < 0.005). p-NETs = pancreatic neuroendocrine tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Survivals for p-NETs with different resections. Patients undergoing radical resections present a statistically better survival than those who only underwent palliative or explorative operations (P < 0.005). p-NETs = pancreatic neuroendocrine tumor.
Mentions: All patients in this study received surgical treatments so that the diagnosis of p-NETs could be histologically confirmed from the resected tissues or biopsies. There were totally 128 patients undergoing radical resections (88%), including local resection of pancreatic tumor (40.0%), distal pancreatectomy (24.8%), pancreaticoduodenectomy (11.2%), and others (12.0%), whereas palliative or explorative operations were performed only on 17 patients (12.0%). With an MST of 88.3 and 18.4 months, respectively, patients undergoing radical resections present a statistically better survival than those who did not (OS at 5 years were 67.1% and NA, respectively) (P < 0.005, Figure 4).

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