Pancreatic endocrine tumors: improved TNM staging and histopathological grading permit a clinically efficient prognostic stratification of patients
| Autor: | Rossella Bettini, William Mantovani, Letizia Boninsegna, Francesco Panzuto, Massimo Falconi, Stefania Beghelli, Paola Capelli, Paolo Pederzoli, Gianfranco Delle Fave, Aldo Scarpa |
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| Přispěvatelé: | Scarpa, A., Mantovani, W., Capelli, P., Beghelli, S., Boninsegna, L., Bettini, R., Panzuto, F., Pederzoli, P., Delle Fave, G., Falconi, Massimo |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male tumors Pathology medicine.medical_specialty Time Factors endocrine Kaplan-Meier Estimate Neuroendocrine tumors World Health Organization Risk Assessment TNM Pathology and Forensic Medicine Predictive Value of Tests Risk Factors pancreas staging grading prognosis Humans Medicine Prospective Studies Stage (cooking) Prospective cohort study Grading (tumors) Survival analysis Aged Cell Proliferation Neoplasm Staging Proportional Hazards Models Chi-Square Distribution Proportional hazards model business.industry Carcinoma Cell Differentiation Middle Aged medicine.disease Immunohistochemistry Pancreatic Neoplasms Ki-67 Antigen medicine.anatomical_structure Italy Lymphatic Metastasis Predictive value of tests Female business Pancreas |
| Popis: | Pancreatic endocrine tumors are rare diseases and devising a clinically effective prognostic stratification of patients is a major clinical challenge. This study aimed at assessing whether the tumor-node-metastasis (TNM)-based staging and proliferative activity-based grading recently proposed by the European NeuroEndocrine Tumors Society (ENETS) have clinical value. TNM was applied to 274 patients with histologically diagnosed pancreatic endocrine tumors operated from 1991 to 2005, with last follow-up at December 2007. According to World Health Organization (WHO) classification, 246 were well-differentiated neoplasms (51 benign, 56 uncertain behavior, 139 carcinomas) and 28 poorly differentiated carcinomas. Grading was based on Ki67 immunohistochemistry. Survival analysis not only ascertained the prognostic value of the TNM system but also highlighted that in the absence of nodal and distant metastasis, infiltration and tumor dimensions over 4 cm had prognostic significance. T parameters were then appropriately modified to reflect this weakness. The 5-year survival for modified TNM stages I, II, III and IV were 100, 93, 65 and 35%, respectively. Multivariate analysis identified TNM stages as independent predictors of death, in which stages II, III and IV showed a risk of death of 7, 29 and 58 times higher than stage I tumors (P |
| Databáze: | OpenAIRE |
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