Increased Grade in Neuroendocrine Tumor Metastases Negatively Impacts Survival

Keck, Kendall J.; Choi, Allen; Maxwell, Jessica; Li, Guiying; O’Dorisio, Thomas M.; Breheny, Patrick; Bellizzi, Andrew M.; Howe, James R.

doi:10.1245/s10434-017-5899-y

Cited by 57 publications

(57 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Gracia P et al [5] reported that the Ki-67 was higher in the metastatic lesion than in the primary lesion in dogs [5]. There are some variations, increasing (24%), stable (66%), and decreasing (10%) of Ki-67 in metastatic lesion in human neuroendocrine tumors [7]. Since Ki-67 can be used for grading or predicting prognosis in human PNSTs [18][19][20] and in canine PNSTs [15], Ki-67 is an available marker for physiological states and prognosis in MPNSTs.…”

mentioning

confidence: 99%

Primary malignant peripheral nerve sheath tumors arising from the spinal canal invading the abdominal cavity in a dog

Narita

Nishida

Goto

et al. 2020

The Journal of Veterinary Medical Science

View full text Add to dashboard Cite

ABSTRAST. A 9-year-old neutered male Wire Fox Terrier presented with an 1-month history of hindlimb paresis. Magnetic resonance imaging revealed a contrast-enhanced mass at the level of the L2 vertebral canal. The dog became paraplegic with no deep perception of the hindlimbs, and the mass was surgically removed. The histopathological diagnosis was of a malignant peripheral nerve sheath tumor (MPNST). The dog suffered a relapse of right hindlimb ataxia at 225 days after the surgery. The dog died 434 days after the surgery. Necropsy found a large mass in the abdominal cavity invading from the L2-nerve. This is the first report of MPNST invading the abdominal cavity through the nerve root.

show abstract

mentioning

confidence: 99%

Primary malignant peripheral nerve sheath tumors arising from the spinal canal invading the abdominal cavity in a dog

Narita

Nishida

Goto

et al. 2020

The Journal of Veterinary Medical Science

View full text Add to dashboard Cite

show abstract

“…Grillo et al found 39% discrepancy in grade between primary and metastatic tumors [33]. Keck KJ et al found grade variation occurred in 34% of patients between primary and metastatic tumors [34]. In our study, we found that, in 54.3% of GEP-NENs patients, the Ki-67 index differed between primary and metastatic lesions; as a result, the WHO classification changed in 8.6% of the patients.…”

Section: Discussionmentioning

confidence: 40%

Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm

et al. 2020

View full text Add to dashboard Cite

Background Chromogranin A (CgA), synaptophysin (Syn) and the Ki-67 index play significant roles in diagnosis or the evaluation of the proliferative activity of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, little is known about whether these biological markers change during tumor metastasis and whether such changes have effect on prognosis. Methods We analyzed 35 specimens of both primary and metastatic tumor from 779 patients who had been diagnosed as GEP-NENs at Wuhan Union Hospital from August 2011 to October 2019. The heterogeneity of CgA, Syn and Ki-67 index was evaluated by immunohistochemical analysis. Results Among these 779 patients, the three most common sites of NENs in the digestive tract were the pancreas, rectum and stomach. Metastases were found in 311 (39.9%) patients. Among the 35 patients with both primary and metastatic pathological specimens, differences in the Ki-67 level were detected in 54.3% of the patients, while 37.1% showed a difference in CgA and only 11.4% showed a difference in Syn. Importantly, due to the difference in the Ki-67 index between primary and metastatic lesions, the WHO grade was changed in 8.6% of the patients. In addition, a Kaplan–Meier survival analysis showed that patients with Ki-67 index variation had a shorter overall survival (p = 0.0346), while neither Syn variation nor CgA variation was related to patient survival (p = 0.7194, p = 0.4829). Conclusions Our data indicate that primary and metastatic sites of GEP-NENs may exhibit pathological heterogeneity. Ki-67 index variation is closely related to the poor prognosis of patients with tumor metastasis, but neither Syn variation nor CgA variation is related to patient prognosis. Therefore, clinicopathologic evaluation of the primary tumor and metastatic sites could be helpful for predicting the prognosis.

show abstract

“…13 The tumor grade was assigned according to the World Health Organization 2010 classification of tumors of the digestive system based on the Ki-67 index and mitotic rate. 14 For patients in whom the Ki-67 index was calculated in both the primary tumor and metastases, the greater value was used to determine overall grade based on the findings of Keck et al 15…”

Section: Methodsmentioning

confidence: 99%

Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs)

Scott

Breheny

Keck

et al. 2019

Surgery

Self Cite

View full text Add to dashboard Cite

Background: Cytoreductive surgery for neuroendocrine tumor liver metastases improves survival and symptomatic control. However, the feasibility of adequate cytoreduction in patients with many liver metastases remains uncertain. We compared patient outcomes based on the number of lesions treated to better define the efficacy of cytoreductive surgery for numerous neuroendocrine tumor liver metastases. Methods: Patients undergoing hepatic cytoreductive surgery for gastroenteropancreatic neuroendocrine tumors were identified in our institutional surgical neuroendocrine tumor database. Imaging studies were reviewed to determine the liver tumor burden and percent cytoreduced. Overall survival and progressionfree survival were compared, using the number of lesions treated, percent tumor debulked, and additional clinicopathologic characteristics. Results: A total of 188 hepatic cytoreductive procedures were identified and stratified into groups according to the number of metastases treated: 1–5, 6–10, and >10. Median overall survival and progressionfree survival were 89.4 and 22.5 months, respectively, and did not differ significantly between groups. Greater than 70% cytoreduction was associated with significantly better overall survival than <70% cytoreduction (134 months versus 38 months). Conclusion: In patients with gastroenteropancreatic neuroendocrine tumors and liver metastases, >70% cytoreduction led to improved overall survival and progression-free survival and was achieved reliably in patients undergoing debulking of > 10 lesions. These data support an aggressive approach to patients with numerous neuroendocrine tumor liver metastases to achieve >70% cytoreduction.

show abstract

Increased Grade in Neuroendocrine Tumor Metastases Negatively Impacts Survival

Cited by 57 publications

References 27 publications

Primary malignant peripheral nerve sheath tumors arising from the spinal canal invading the abdominal cavity in a dog

Primary malignant peripheral nerve sheath tumors arising from the spinal canal invading the abdominal cavity in a dog

Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm

Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs)

Contact Info

Product

Resources

About