Medline ® Abstract for Reference 29
of 'Pathology, classification, and grading of neuroendocrine tumors arising in the digestive system'
Prognostic Validity of the American Joint Committee on Cancer and the European Neuroendocrine Tumors Staging Classifications for Pancreatic Neuroendocrine Tumors: A Retrospective Nationwide Multicenter Study in South Korea.
Cho JH, Ryu JK, Song SY, Hwang JH, Lee DK, Woo SM, Joo YE, Jeong S, Lee SO, Park BK, Cheon YK, Han J, Kim TN, Lee JK, Moon SH, Kim H, Park ET, Hwang JC, Kim TH, Jeon TJ, Cho CM, Choi HS, Lee WJ
OBJECTIVES: Pancreatic neuroendocrine tumors (pNETs) are diverse diseases with different prognosis. The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) introduced 2 different tumor node metastasis (TNM) stages, and the World Health Organization (WHO) proposed WHO 2010 grading system for pNETs. Therefore, we aimed to validate the prognostic relevance of these 3 systems for pNETs in South Korea.
METHODS: The Korean Society of Gastrointestinal Cancer created a retrospective registry of pNETs in 153 patients from 15 hospitals between 2002 and 2012.
RESULTS: On the basis of the WHO 2010 grade, 2-year progression-free-survival (PFS) rates for G1, G2, and G3 were 92%, 62%, and 25% (P<0.01). According to ENETS and AJCC staging, 2-year PFS rates for stages I through IV were 94%, 87%, 49%, 20%, and 92%, 61%, 60%, 20%, respectively (P<0.01). A Cox multivariate regression analysis revealed that the only statistically significant prognostic factor was the TNM classification of either the AJCC or the ENETS stage (P<0.01). In addition, theκvalue between the AJCC and the ENETS stages was 0.46 indicating a "moderate" agreement (P<0.01).
CONCLUSIONS: The AJCC and ENETS TNM classifications for pNETs are prognostic for PFS and can be adopted in clinical practice in South Korea.
From the *Department of Internal Medicine, Gachon University Gil Medical Center, Incheon;†Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul;‡Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul;§Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang;∥Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul;¶Center for Liver Cancer, National Cancer Center, Goyang; #Department of Internal Medicine, Chonnam National University Medical School, Gwangju; **Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon;††Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Jeonju;‡‡Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang;§§Depar