A New Scoring System to Predict Recurrent Disease in Grade 1 and 2 Nonfunctional Pancreatic Neuroendocrine Tumors
| Autor: | Anneke P. J. Jilesen, S. van Eeden, F. J. van Kemenade, Stefano Partelli, Francesca Muffatti, S. van Dieren, Cansu Guney Genc, J. Verheij, E. J. M. Nieveen van Dijkum, Massimo Falconi, C.H.J. van Eijck |
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| Přispěvatelé: | Surgery, CCA - Cancer Treatment and Quality of Life, Pathology, APH - Methodology, AGEM - Digestive immunity, Genc, C. G., Jilesen, A. P., Partelli, S., Falconi, M., Muffatti, F., Van Kemenade, F. J., Van Eeden, S., Verheij, J., Van Dieren, S., Van Eijck, C. H. J., Nieveen Van Dijkum, E. J. M. |
| Rok vydání: | 2018 |
| Předmět: |
Oncology
Male medicine.medical_specialty Scoring system recurrence Non functional Neuroendocrine tumors Gastroenterology nomogram 03 medical and health sciences 0302 clinical medicine Postoperative Complications Recurrence Internal medicine medicine Recurrent disease Humans In patient Neoplasm Invasiveness Aged Proportional Hazards Models Retrospective Studies Neoplasm Grading pancreatic neuroendocrine tumors Hepatology Proportional hazards model business.industry Retrospective cohort study Nomogram Middle Aged medicine.disease Surgery Pancreatic Neoplasms Nomograms 030220 oncology & carcinogenesis Lymphatic Metastasis 030211 gastroenterology & hepatology Female Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Annals of surgery, 267(6). Lippincott Williams and Wilkins Annals of Surgery, 267(6), 1148-1154. Lippincott Williams & Wilkins |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000002123 |
| Popis: | Objective: The aim of this study was to predict recurrence in patients with grade 1 or 2 nonfunctioning pancreatic neuroendocrine tumors (NF-pNET) after curative resection. Background: Surgical resection is the preferred treatment for NF-pNET; however, recurrence occurs frequently after curative surgery, worsening prognosis of patients. Methods: Retrospectively, patients with NF-pNET of 3 institutions were included. Patients with distant metastases, hereditary syndromes, or grade 3 tumors were excluded. Local or distant tumor recurrence was scored. Independent predictors for survival and recurrence were identified using Cox-regression analysis. The recurrence score was developed to predict recurrence within 5 years after curative resection of grade 1 to 2 NF-pNET. Results: With a median follow-up of 51 months, 211 patients with grade 1 to 2 NF-pNET were included. Thirty-five patients (17%) developed recurrence. The 5- and 10-year disease-specific/overall survival was 98%/91% and 84%/68%, respectively. Predictors for recurrence were tumor grade 2, lymph node metastasis, and perineural invasion. On the basis of these predictors, the recurrence score was made. Discrimination [c-statistic 0.81, 95% confidence interval (95% CI) 0.75-0.87] and calibration (Hosmer Lemeshow Chi-square 11.25, P = 0.258) indicated that the ability of the recurrence score to identify patients at risk for recurrence is good. Conclusions: This new scoring system could predict recurrence after curative resection of grade 1 and 2 NF-pNET. With the use of the recurrence score, less extensive follow-up could be proposed for patients with low recurrence risk. For high-risk patients, clinical trials should be initiated to investigate whether adjuvant therapy might be beneficial. External validation is ongoing due to limited availability of adequate cohorts. |
| Databáze: | OpenAIRE |
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