Pancreatic neuroendocrine tumours: Grade is superior to T, N, or M status in predicting outcome and selecting patients for chemotherapy:A retrospective cohort study in the SEER database

Zhai, Huamin; Li, Duguang; Feng, Qingbo; Qian, Xiaowei; Li, Ling; Yao, Jie

doi:10.1016/j.ijsu.2019.03.006

Cited by 18 publications

(13 citation statements)

References 28 publications

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“…The prognostic relevance of tumor grading, as first proposed in Europe more than a decade ago 31 and eventually embraced by clinicians worldwide, [32][33][34] is also supported by observations in this study.…”

Section: Discussionsupporting

confidence: 84%

“…Tumor grade not only serves as a prognostic factor but may also serve as a predictive factor for the selection of GEP-NEN patients for chemotherapy treatment, 34 particularly in cases with a welldifferentiated morphology despite a high Ki67 index (>55%). 38 In line with long-standing treatment principles, surgical treatment was used whenever feasible.…”

Section: Discussionmentioning

confidence: 99%

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The overriding role of surgery and tumor grade for long‐term survival in patients with gastroenteropancreatic neuroendocrine neoplasms: A population‐based cohort study

et al. 2021

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Background: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) comprise a heterogeneous disease group. Factors that affect long-term survival remain uncertain.Complete population-representative cohorts with long-term follow-up are scarce.Aim: To evaluate factors of importance for the long-term survival.Methods and results: An Observational population-based study on consecutive GEP-NEN patients diagnosed from 2003 to 2013, managed according to national guidelines.Univariable and multivariable survival analyses were performed to evaluate overall survival (OS) and to identify independent prognostic factors. One hundred ninety eligible patients (males, 58.9%) (median age, 60.0 years; range, 10.0-94.2 years) were included.The small bowel, appendix, and pancreas were the most common tumor locations. The World Health Organization (WHO) tumor grade 1-3 distributions varied according to the primary location and disease stage. Primary surgery with curative intent was performed in 66% of the patients. The median OS of the study population was 183 months with 5-and 10-year OS rates of 66% and 57%, respectively. Only age, WHO tumor grade, and primary surgical treatment were independent prognostic factors for OS. Conclusion:The outcomes of GEP-NEN patients are related to several factors including age and primary surgical treatment. WHO tumor grading, based on the established criteria, should be routine in clinical practice. This may improve clinical decision-making and allow the comparison of outcomes among different centers.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

The overriding role of surgery and tumor grade for long‐term survival in patients with gastroenteropancreatic neuroendocrine neoplasms: A population‐based cohort study

et al. 2021

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“…[ 17 – 19 ] On the other hand, chemotherapy regimens such as somatostatin analogs are the first-line treatment for patients unable to undergo surgical resection. [ 7 , 17 ]. However, both modalities do not rule out the possibility of disease recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…However, only a few comprehensive analyses on pNEN in a large population are currently available, hence the need for more studies to benefit epidemiologic exploration and help find new therapeutic strategies. Pathological analysis of the grade of differentiation might contribute to prognostic assessment and therapy selection [ 7 ]. Socioeconomic status (SES), which is related to many malignancies, was reported to be associated with the financial ability of patients to shoulder the cost burden of effective specific diagnosis and timely medical inferences [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in Incidence and Survival of Patients with Pancreatic Neuroendocrine Neoplasm, 1987–2016

Wang

Jian-hua

et al. 2021

Journal of Oncology

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Background. Pancreatic neuroendocrine neoplasm (pNEN), with the lowest 5-year survival rates in neuroendocrine tumors (NETs), exerts great threat to human health. Because large-scale population research aimed at pNEN is rare, we aimed to explore the tendencies and differences of changes in incidences and survival rates of pNEN in each decade from 1987 to 2016 and evaluate the impacts of age, sex, race, socioeconomic status (SES), and grade. Methods. Data on pNEN cases from 1987 to 2016 were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Kaplan–Meier, Cox proportional hazards regression analyses, and relative survival rates (RSRs) were used to identify risk factors for pNEN. Results. The incidence and survival duration of pNEN increase every decade due to medical developments. The disparities of long-term survival in different age, sex, and grade groups expanded over time while that in race and SES groups narrowed. Older age and higher grade are independent risk factors for poorer survival. Females have lower incidence and longer survival than males. Prognosis of Black patients and poor (medium and high poverty) patients improved. Conclusions. This study depicted changes in incidence and survival rates of pNEN over the past three decades and evaluated potential risk factors related to pNEN, benefiting future prediction of vulnerable and clinical options.

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“…NENs, in general, are clinically challenging because they are slow growing, biologically diverse tumors that lack effective therapies once they become metastatic. Gastroenteropancreatic NENs often elude diagnosis for years; consequently, ~ 40% of patients or more have liver metastases at the time of diagnosis 1 – 6 . While considered rare, NENs progress relentlessly and the most frequent types (arising in the pancreas, small bowel and lung) have risen 4- to 6-fold in incidence over the last few decades 1 – 3 .…”

Section: Introductionmentioning

confidence: 99%

Development and comparison of novel bioluminescent mouse models of pancreatic neuroendocrine neoplasm metastasis

Kaemmer

Umesalma

Maharjan

et al. 2021

Sci Rep

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Pancreatic neuroendocrine neoplasms (pNENs) are slow growing cancers of increasing incidence that lack effective treatments once they become metastatic. Unfortunately, nearly half of pNEN patients present with metastatic liver tumors at diagnosis and current therapies fail to improve overall survival. Pre-clinical models of pNEN metastasis are needed to advance our understanding of the mechanisms driving the metastatic process and for the development of novel, targeted therapeutic interventions. To model metastatic dissemination of tumor cells, human pNEN cell lines (BON1 and Qgp1) stably expressing firefly luciferase (luc) were generated and introduced into NSG immunodeficient mice by intracardiac (IC) or intravenous (IV) injection. The efficiency, kinetics and distribution of tumor growth was evaluated weekly by non-invasive bioluminescent imaging (BLI). Tumors formed in all animals in both the IC and IV models. Bioluminescent Qgp1.luc cells preferentially metastasized to the liver regardless of delivery route, mimicking the predominant site of pNEN metastasis in patients. By comparison, BON1.luc cells most commonly formed lung tumors following either IV or IC administration and colonized a wider variety of tissues than Qgp1.luc cells. These models provide a unique platform for testing candidate metastasis genes and anti-metastatic therapies for pNENs.

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Pancreatic neuroendocrine tumours: Grade is superior to T, N, or M status in predicting outcome and selecting patients for chemotherapy:A retrospective cohort study in the SEER database

Cited by 18 publications

References 28 publications

The overriding role of surgery and tumor grade for long‐term survival in patients with gastroenteropancreatic neuroendocrine neoplasms: A population‐based cohort study

The overriding role of surgery and tumor grade for long‐term survival in patients with gastroenteropancreatic neuroendocrine neoplasms: A population‐based cohort study

Trends in Incidence and Survival of Patients with Pancreatic Neuroendocrine Neoplasm, 1987–2016

Development and comparison of novel bioluminescent mouse models of pancreatic neuroendocrine neoplasm metastasis

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