Dataset Information

A modified M-stage classification based on the metastatic patterns of pancreatic neuroendocrine neoplasms: a population-based study.

ABSTRACT:

Background

The present study aims to improve the M-stage classification of pancreatic neuroendocrine neoplasms (pNENs).

Methods

Two thousand six hundred sixty six pNENs were extracted from the Surveillance, Epidemiology, and End Results database to explore the metastatic patterns of pNENs. Metastatic patterns were categorized as single, two, or multiple (three or more) distant organ metastasis. The mean overall survival and hazard rate of different metastatic patterns were calculated by Kaplan-Meier and Cox proportional hazards models, respectively. The discriminatory capability of the modified M-stage classification was evaluated by Harrell's concordance index.

Results

The overall survival time significantly decreased with an increasing number of metastatic organs. In addition, pNENs with only liver metastasis had better prognosis when compared to other metastatic patterns. Thus, we modified the M-stage classification (mM-stage) as follows: mM₀-stage, tumor without metastasis; mM₁-stage, tumor only metastasized to liver; mM₂-stage, tumor metastasized to other single distant organ (lung, bone, or brain) or two distant organs; mM₃-stage, tumor metastasized to three or more distant organs. Harrell's concordance index showed that the modified M-stage classification had superior discriminatory capability than both the American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) M-stage classifications.

Conclusions

The modified M-stage classification is superior to both AJCC and ENETS M-stage classifications in the prognosis of pNENs. In the future, individualized treatment and follow-up programs should be explored for patients with distinct metastatic patterns.

SUBMITTER: Zhang X

PROVIDER: S-EPMC6194708 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

A modified M-stage classification based on the metastatic patterns of pancreatic neuroendocrine neoplasms: a population-based study.

Zhang Xianbin X Song Jiaxin J Liu Peng P Mazid Mohammad Abdul MA Lu Lili L Shang Yuru Y Wei Yushan Y Gong Peng P Ma Li L

BMC endocrine disorders 20181019 1

<h4>Background</h4>The present study aims to improve the M-stage classification of pancreatic neuroendocrine neoplasms (pNENs).<h4>Methods</h4>Two thousand six hundred sixty six pNENs were extracted from the Surveillance, Epidemiology, and End Results database to explore the metastatic patterns of pNENs. Metastatic patterns were categorized as single, two, or multiple (three or more) distant organ metastasis. The mean overall survival and hazard rate of different metastatic patterns were calcula ...[more]

PMID: 30340569

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Project description:BackgroundSeveral risk factors predict clinical outcome in gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs); however, the impact of their combination has not been investigated so far.Patients and methodsA retrospective analysis of stage IV GEP-NENs was performed. Multivariate analysis for progression of disease (PD) was performed by Cox proportional hazards method to obtain a risk score. Area under the curve obtained by receiver operating characteristic analysis was used to assess the score performance. Progression-free survival analysis was performed by Kaplan-Meier method.ResultsTwo hundred eighty-three stage IV GEP-NENs were evaluated, including 93 grade 1 neuroendocrine tumors (32.9%), 153 grade 2 neuroendocrine tumors (54%), and 37 grade 3 neuroendocrine carcinomas (13.1%). Independent risk factors for PD were Ki67, proportion of metastatic liver involvement, and presence of extra-abdominal metastases. The risk score was calculated as follows: (0.025 × Ki67) + [(0 if no liver metastases or liver involvement <25%) OR (0.405 if liver involvement 25%-50%) OR (0.462 if liver involvement >50%)] + [(0 if no extra-abdominal metastases) OR (0.528 if extra-abdominal metastases present)]. The risk score accuracy to predict PD was superior compared with the G grading system (area under the curve: 0.705 and 0.622, respectively). Three subgroups of patients with low, intermediate, and high risk of PD according to risk score were identified, median progression-free survival being 26 months, 19 months, and 12 months, respectively.ConclusionIn stage IV GEP-NENs, a risk score able to predict PD was obtained by combining Ki67, proportion of metastatic liver involvement, and presence of extra-abdominal metastases. The score may help to discriminate patients with different progression risk level to plan tailored therapeutic approaches and follow-up programs. The Oncologist 2017;22:409-415Implications for Practice: Clinical outcome of patients with advanced gastro-entero-pancreatic neuroendocrine neoplasms is affected by several risk factors, including the proliferative index Ki67, extension of liver metastases, and the presence of distant extra-abdominal lesions. A risk score that combines these variables may help physicians dealing with these diseases to plan the optimal therapeutic approach and follow-up program.

Dataset Information

A modified M-stage classification based on the metastatic patterns of pancreatic neuroendocrine neoplasms: a population-based study.

Background

Methods

Results

Conclusions

Publications

A modified M-stage classification based on the metastatic patterns of pancreatic neuroendocrine neoplasms: a population-based study.

Similar Datasets

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