PMID- 26602841
OWN - NLM
STAT- MEDLINE
DCOM- 20160617
LR  - 20171210
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 159
IP  - 3
DP  - 2016 Mar
TI  - Long-term outcomes and prognostic factors in neuroendocrine carcinomas of the 
      pancreas: Morphology matters.
PG  - 862-71
LID - S0039-6060(15)00791-6 [pii]
LID - 10.1016/j.surg.2015.09.012 [doi]
AB  - BACKGROUND: Limited data are available for pancreatic neuroendocrine carcinomas 
      (NEC) defined by 2010 World Health Organization (WHO) criteria (mitotic count >20 
      mitoses/10 high-power fields and/or a Ki67 index of >20%), because most studies 
      encompass heterogeneous cohorts of extrapulmonary/gastrointestinal NEC. Our aim 
      was to evaluate the clinicopathologic characteristics, treatment, and prognosis 
      of patients with pancreatic NEC defined by the 2010 WHO criteria. METHODS: We 
      conducted a retrospective analysis of 59 patients with a histologic diagnosis of 
      NEC between 1990 and 2012. All cases were re-reviewed and classified according to 
      the WHO 2010 classification and the WHO 2000 criteria. RESULTS: All patients had 
      stage III pancreatic NEC (n = 34; 58%) or IV pancreatic NEC (n = 25; 43%). 
      Overall, 49 (83%) had poorly differentiated (PD) and 10 (17%) had a 
      well-differentiated (WD) morphology. Fifteen patients (26%) were operated with 
      curative intent (R0/R1), and 8 (14%) were R2 resections. Median disease-specific 
      survival (DSS) for the entire cohort was 14 months. Median DSS did not differ 
      between patient not undergoing resection and those undergoing R2 resection (10 vs 
      12 months; P > .46), but DSS was greater for patients who underwent R0/R1 
      resection compared with those with no resection/R2 resection (35 vs 11 months; P 
      < .005). WD morphologic NEC had a greater survival than PD ones (43 vs 12 months; 
      P = .004). Performance status, R2 resection/no resection, PD morphologic NEC, and 
      no medical treatment were independent predictors of poor survival. CONCLUSION: 
      Pancreatic NEC constitute a heterogeneous group of tumors. Although NEC is an 
      aggressive disease, curative resection in localized disease is associated with 
      improved survival. Morphologic WD pancreatic NEC represents a subgroup with what 
      seems to be a markedly improved survival. Within the NEC category, tumor 
      treatment should be individualized considering tumor morphology as well as the 
      other 2010 WHO criteria.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Crippa, Stefano
AU  - Crippa S
AD  - Division of Pancreatic Surgery, Universita Politecnica delle Marche, Ospedali 
      Riuniti, Ancona, Italy.
FAU - Partelli, Stefano
AU  - Partelli S
AD  - Division of Pancreatic Surgery, Universita Politecnica delle Marche, Ospedali 
      Riuniti, Ancona, Italy.
FAU - Bassi, Claudio
AU  - Bassi C
AD  - Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
FAU - Berardi, Rossana
AU  - Berardi R
AD  - Department of Medical Oncology, Universita Politecnica delle Marche, Ospedali 
      Riuniti, Ancona, Italy.
FAU - Capelli, Paola
AU  - Capelli P
AD  - Department of Pathology, ARC-Net Research Centre, University and Hospital Trust 
      of Verona, Verona, Italy.
FAU - Scarpa, Aldo
AU  - Scarpa A
AD  - Department of Pathology, ARC-Net Research Centre, University and Hospital Trust 
      of Verona, Verona, Italy.
FAU - Zamboni, Giuseppe
AU  - Zamboni G
AD  - Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy.
FAU - Falconi, Massimo
AU  - Falconi M
AD  - Division of Pancreatic Surgery, Universita Politecnica delle Marche, Ospedali 
      Riuniti, Ancona, Italy. Electronic address: falconi.massimo@hsr.it.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
CIN - Surgery. 2016 Dec;160(6):1709. PMID: 26968350
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Carcinoma, Neuroendocrine/mortality/*pathology/*therapy
MH  - Cohort Studies
MH  - Combined Modality Therapy
MH  - Databases, Factual
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoadjuvant Therapy/*methods
MH  - Neoplasm Invasiveness/pathology
MH  - Neoplasm Staging
MH  - Pancreatectomy/methods/mortality
MH  - Pancreatic Neoplasms/mortality/*pathology/*therapy
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Statistics, Nonparametric
MH  - Survival Analysis
EDAT- 2015/11/26 06:00
MHDA- 2016/06/18 06:00
CRDT- 2015/11/26 06:00
PHST- 2014/11/25 00:00 [received]
PHST- 2015/08/25 00:00 [revised]
PHST- 2015/09/11 00:00 [accepted]
PHST- 2015/11/26 06:00 [entrez]
PHST- 2015/11/26 06:00 [pubmed]
PHST- 2016/06/18 06:00 [medline]
AID - S0039-6060(15)00791-6 [pii]
AID - 10.1016/j.surg.2015.09.012 [doi]
PST - ppublish
SO  - Surgery. 2016 Mar;159(3):862-71. doi: 10.1016/j.surg.2015.09.012.