PMID- 24403235
OWN - NLM
STAT- MEDLINE
DCOM- 20140916
LR  - 20211021
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Print)
IS  - 2045-7634 (Linking)
VI  - 2
IP  - 5
DP  - 2013 Oct
TI  - Hormone profiling, WHO 2010 grading, and AJCC/UICC staging in pancreatic 
      neuroendocrine tumor behavior.
PG  - 701-11
LID - 10.1002/cam4.96 [doi]
AB  - Pancreatic neuroendocrine tumors (pNETs) are the second most common pancreatic 
      neoplasms, exhibiting a complex spectrum of clinical behaviors. To examine the 
      clinico-pathological characteristics associated with long-term prognosis we 
      reviewed 119 patients with pNETs treated in a tertiary referral center using the 
      WHO 2010 grading and the American Joint Committee on Cancer/International Union 
      Against Cancer (AJCC/UICC) staging systems, with a median follow-up of 38 months. 
      Tumor size, immunohistochemistry (IHC) profiling and patient 
      characteristics-determining stage were analyzed. Primary clinical outcomes were 
      disease progression or death. The mean age at presentation was 52 years; 55% were 
      female patients, 11% were associated with MEN1 (multiple endocrine neoplasia 1) 
      or VHL (Von Hippel-Lindau); mean tumor diameter was 3.3 cm (standard deviation, 
      SD) (2.92). The clinical presentation was incidental in 39% with endocrine 
      hypersecretion syndromes in only 24% of cases. Nevertheless, endocrine hormone 
      tissue immunoreactivity was identified in 67 (56.3%) cases. According to WHO 2010 
      grading, 50 (42%), 38 (31.9%), and 3 (2.5%) of tumors were low grade (G1), 
      intermediate grade (G2), and high grade (G3), respectively. Disease progression 
      occurred more frequently in higher WHO grades (G1: 6%, G2: 10.5%, G3: 67%, P = 
      0.026) and in more advanced AJCC stages (I: 2%, IV: 63%, P = 0.033). Shorter 
      progression free survival (PFS) was noted in higher grades (G3 vs. G2; 21 vs. 144 
      months; P = 0.015) and in more advanced AJCC stages (stage I: 218 months, IV: 24 
      months, P < 0.001). Liver involvement (20 vs. 173 months, P < 0.001) or 
      histologically positive lymph nodes (33 vs. 208 months, P < 0.001) were 
      independently associated with shorter PFS. Conversely, tissue endocrine hormone 
      immunoreactivity, independent of circulating levels was significantly associated 
      with less aggressive disease. Age, gender, number of primary tumors, and heredity 
      were not significantly associated with prognosis. Although the AJCC staging and 
      WHO 2010 grading systems are useful in predicting disease progression, tissue 
      endocrine hormone profiling provides additional information of potentially 
      important prognostic value.
CI  - (c) 2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Morin, Emilie
AU  - Morin E
AD  - Department of Medicine, Princess Margaret Cancer Centre, University Health 
      Network, Toronto, Ontario, Canada.
FAU - Cheng, Sonia
AU  - Cheng S
FAU - Mete, Ozgur
AU  - Mete O
FAU - Serra, Stefano
AU  - Serra S
FAU - Araujo, Paula B
AU  - Araujo PB
FAU - Temple, Sara
AU  - Temple S
FAU - Cleary, Sean
AU  - Cleary S
FAU - Gallinger, Steven
AU  - Gallinger S
FAU - Greig, Paul D
AU  - Greig PD
FAU - McGilvray, Ian
AU  - McGilvray I
FAU - Wei, Alice
AU  - Wei A
FAU - Asa, Sylvia L
AU  - Asa SL
FAU - Ezzat, Shereen
AU  - Ezzat S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130806
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 0 (Antineoplastic Agents, Hormonal)
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Hormones)
RN  - RWM8CCW8GP (Octreotide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents, Hormonal/therapeutic use
MH  - Biomarkers, Tumor/*metabolism
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Hormones/*metabolism
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Neoplasms/secondary
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Grading
MH  - Neoplasm Staging
MH  - Neuroendocrine Tumors/diagnosis/drug therapy/*pathology/secondary
MH  - Octreotide/therapeutic use
MH  - Pancreatic Neoplasms/diagnosis/drug therapy/*pathology
MH  - Prognosis
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC3892801
OTO - NOTNLM
OT  - Carcinoid
OT  - gastrinoma
OT  - insulinoma
OT  - neuroendocrine tumors
OT  - pNET
EDAT- 2014/01/10 06:00
MHDA- 2014/09/17 06:00
PMCR- 2013/10/01
CRDT- 2014/01/10 06:00
PHST- 2013/03/15 00:00 [received]
PHST- 2013/04/19 00:00 [revised]
PHST- 2013/05/12 00:00 [accepted]
PHST- 2014/01/10 06:00 [entrez]
PHST- 2014/01/10 06:00 [pubmed]
PHST- 2014/09/17 06:00 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - 10.1002/cam4.96 [doi]
PST - ppublish
SO  - Cancer Med. 2013 Oct;2(5):701-11. doi: 10.1002/cam4.96. Epub 2013 Aug 6.