PMID- 27684993
OWN - NLM
STAT- MEDLINE
DCOM- 20170719
LR  - 20181113
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Print)
IS  - 0147-5185 (Linking)
VI  - 41
IP  - 1
DP  - 2017 Jan
TI  - Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a 
      Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor 
      Prognosis.
PG  - 128-133
AB  - Mesenteric tumor deposits (MTDs) are not included in the American Joint Committee 
      on Cancer (AJCC) staging system for midgut small intestinal neuroendocrine tumors 
      (NETs). We examined the prognostic significance of MTDs associated with midgut 
      NETs. Hematoxylin and eosin slides from 132 resected jejunal/ileal NETs were 
      reviewed for AJCC tumor stage, lymph node (LN) metastasis, MTDs, and hepatic 
      metastases. MTDs were defined as discrete irregular mesenteric tumor nodules 
      discontinuous from the primary tumor. Clinical or pathologic evidence of 
      metastases and survival data were abstracted from electronic medical records. The 
      cohort included 72 male and 60 female patients with a median age of 60 years. LN 
      metastasis, MTDs, and liver metastasis were present in 80%, 68%, and 58% of 
      patients, respectively. Female sex and presence of MTDs were independent 
      predictors of liver metastasis. The odds ratio for hepatic metastasis in the 
      presence of MTDs was 16.68 (95% confidence interval [CI], 4.66-59.73) and 0.81 
      (95% CI, 0.20-3.26) for LN metastasis. Age, MTDs, and hepatic metastasis were 
      associated with disease-specific survival (DSS) in univariate analysis. Primary 
      tumor histologic grade, pT3/T4 stage, and LN metastasis were not associated with 
      DSS. Multivariate analysis of liver metastasis-free survival stratified by tumor 
      grade showed that MTDs were associated with adverse outcomes. The hazard ratio 
      for MTDs was 4.58 (95% CI, 1.89-11.11), compared with 0.98 (95% CI, 0.47-2.05) 
      for LN metastasis. MTDs, but not LN metastasis, in midgut NETs are a strong 
      predictor for hepatic metastasis and are associated with poor DSS.
FAU - Fata, Cynthia R
AU  - Fata CR
AD  - *Department of Pathology, Microbiology, and Immunology, Vanderbilt University 
      Medical Center, Nashville, TN daggerDepartment of Pathology, University of Rochester 
      Medical Center, Rochester, NY double daggerDepartment of Surgery, Rocky Mountain Cancer 
      Centers, Denver, CO.
FAU - Gonzalez, Raul S
AU  - Gonzalez RS
FAU - Liu, Eric
AU  - Liu E
FAU - Cates, Justin M
AU  - Cates JM
FAU - Shi, Chanjuan
AU  - Shi C
LA  - eng
GR  - P30 DK058404/DK/NIDDK NIH HHS/United States
GR  - P50 CA095103/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Intestinal Neoplasms/mortality/*pathology
MH  - Intestine, Small/pathology
MH  - Kaplan-Meier Estimate
MH  - Liver Neoplasms/mortality/secondary
MH  - Lymphatic Metastasis/pathology
MH  - Male
MH  - Mesentery/*pathology
MH  - Middle Aged
MH  - Neuroendocrine Tumors/mortality/*pathology
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Young Adult
PMC - PMC5159256
MID - NIHMS813979
COIS- The authors have no conflicts of interest
EDAT- 2016/09/30 06:00
MHDA- 2017/07/20 06:00
PMCR- 2018/01/01
CRDT- 2016/09/30 06:00
PHST- 2016/09/30 06:00 [pubmed]
PHST- 2017/07/20 06:00 [medline]
PHST- 2016/09/30 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1097/PAS.0000000000000751 [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2017 Jan;41(1):128-133. doi: 10.1097/PAS.0000000000000751.