Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3

Merola, Elettra; Falconi, Massimo; Rinke, Anja; Staettner, S.; Krendl, Felix J.; Partelli, Stefano; Andreasi, Valentina; Gress, Thomas M.; Pascher, Andreas; Arsenić, Ruža; Doglioni, Claudio; Kaemmerer, Daniel; Wiedenmann, Bertram; Pavel, Marianne

doi:10.1016/j.amjsurg.2020.03.009

Cited by 19 publications

(16 citation statements)

References 29 publications

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“…The eight studies finally selected were all retrospective studies [ 6 , 9 , 10 , 18 , 19 , 20 , 21 , 22 ] including a total of 268 patients with NECs in which Ki67 LI was specified to distinguish two subcategories: NECs with Ki67 LI <55% and NECs with Ki67 LI ≥55% ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…All studies differed according to types of NEN enrolled and treatments received. Specifically, four studies considered both WD G3 NENs and PD-NENs [ 6 , 19 , 21 , 22 ], while four studies [ 9 , 10 , 18 , 20 ] included only patients presenting the specific subgroup of NECs. NENs derived from different primary sites, the most frequent one being the GEP tract.…”

Section: Resultsmentioning

confidence: 99%

“…The study of Milione et al considered patients treated with chemotherapy: platinum-etoposide ( n = 59), other platinum-based regimen ( n = 31), non-platinum-based chemotherapy ( n = 12), and other non-cytotoxic therapy ( n = 8), but unfortunately when the authors stratified the tumors according to the Ki67 LI, they did not provide specific data on the chemotherapy regimen [ 6 ]. In four studies, chemotherapy was used combined with other treatment strategies (radiotherapy and/or surgery), specific data on use and outcome of standard first line therapy cannot be extracted from these studies [ 18 , 20 , 21 , 22 ]. One study evaluated PRRT efficacy [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Data about primary NEC site for each Ki67 LI-based subgroup could be extracted from five studies [ 6 , 9 , 18 , 21 , 22 ] ( n = 189). Pancreas was the prevalent site: among the 62 tumors with a Ki67 LI <55%, 32 had a pNEC (50.8%), whereas 48 out of 127 tumors with a Ki67 LI ≥55% had a pNEC (37.8%).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported on morphology of the different subgroups of patients [ 9 , 20 , 21 , 22 ] ( n = 37): among 12 GEP-NECs with a Ki67 LI <55%, 8 were LC carcinomas (66.7%) while 4 had a SC morphology (33.3%); instead, in the subgroup with a Ki67 LI ≥55%, there were 6/14 GEP-NECs with a LC morphology (42.8%) and 8/14 cases with a SC morphology (57.14%). We only considered lung NECs with a LC morphology ( n = 11, 100%).…”

Section: Resultsmentioning

confidence: 99%

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Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review

Feola

Centello

Sesti

et al. 2021

Cancers

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Background: Highly proliferative (G3) neuroendocrine neoplasms are divided into well differentiated tumors (NETs) and poorly differentiated carcinomas (NECs), based on the morphological appearance. This systematic review aims to evaluate the clinicopathological features and the treatment response of the NEC subgroup with a Ki67 labeling index (LI) < 55%. Methods: A literature search was performed using MEDLINE, Cochrane Library, and Scopus between December 2019 and April 2020, last update in October 2020. We included studies reporting data on the clinicopathological characteristics, survival, and/or therapy efficacy of patients with NECs, in which the Ki67 LI was specified. Results: 8 papers were included, on a total of 268 NEC affected patients. NECs with a Ki67 LI < 55% have been reported in patients of both sexes, mainly of sixth decade, pancreatic origin, and large-cell morphology. The prevalent treatment choice was chemotherapy, followed by surgery and, in only one study, peptide receptor radionuclide therapy. The subgroup of patients with NEC with a Ki67 LI < 55% showed longer overall survival and progression free survival and higher response rates than the subgroup of patients with a tumor with higher Ki67 LI (≥55%). Conclusions: NECs are heterogeneous tumors. The subgroup with a Ki67 LI < 55% has a better prognosis and should be treated and monitored differently from NECs with a Ki67 LI ≥ 55%.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review

Feola

Centello

Sesti

et al. 2021

Cancers

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Surgical outcomes of gastro‐entero‐pancreatic neuroendocrine tumors G3 versus neuroendocrine carcinoma

Lopez‐Aguiar

Poultsides

et al. 2022

Journal of Surgical Oncology

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Background To define surgical outcomes of patients with high‐grade gastro‐entero‐pancreatic neuroendocrine neoplasm grade G3 (GEP‐NEN G3). Methods Patients who underwent surgical resection between 2000 and 2016 were identified. The overall survival (OS) and recurrence‐free survival (RFS) of patients with gastro‐entero‐pancreatic neuroendocrine tumors grade G3 (GEP‐NET G3) versus neuroendocrine carcinoma (NEC) were evaluated. Results Fifty‐one out of 2182 (2.3%) patients who underwent surgical resection were diagnosed as GEP‐NEN G3. The pancreas was the most common primary site (n = 3772.5%). A majority of patients had lymph node metastasis (n = 3262.7%); one in three (n = 1631.4%) had distant metastasis. The median OS and RFS of the entire cohort were 56.4 and 34.5 months, respectively. Perineural invasion was a strong prognostic factor associate with OS after surgical resection. Patients with NEC had a worse survival outcome versus patients with NET G3 (median OS: 33.1 months vs. not attained, p = 0.088). In contrast, among patients who underwent curative‐intent resection, patients with NEC had comparable RFS versus patients with NET G3 (median RFS: 35.6 vs. 33.9 months, p = 0.774). Conclusions Surgical resection provided acceptable short‐ and long‐outcomes for well‐selected patients with resectable GEP‐NEN G3. NEC was associated with a worse OS versus NET G3.

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New Surgical Strategies

Andreasi

Partelli

Muffatti

et al. 2021

Neuroendocrine Neoplasia Management

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Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3

Cited by 19 publications

References 29 publications

Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review

Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review

Surgical outcomes of gastro‐entero‐pancreatic neuroendocrine tumors G3 versus neuroendocrine carcinoma

New Surgical Strategies

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