TY - JOUR
T1 - Outcome after pancreatectomy for neuroendocrine neoplams according to the WHO 2017 grading system
T2 - A retrospective multicentric analysis of 138 consecutive patients
AU - Renaten Languedoc-Roussillon Study Group
AU - Réseau de référence clinique pour les tumeurs endocrines malignes sporadiques et héréditaires
AU - Souche, Regis
AU - Coignac, Antoine
AU - Dupuy, Marie
AU - Bertrand, Martin
AU - Raingeart, Isabelle
AU - Guiu, Boris
AU - Herrero, Astrid
AU - Panaro, Fabrizio
AU - Obled, Stephane
AU - Portales, Fabienne
AU - Riviere, Benjamin
AU - Ramos, Jeanne
AU - Borie, Frederic
AU - Quenet, Francois
AU - Colombo, Pierre Emmanuel
AU - Prudhomme, Michel
AU - Assenat, Eric
AU - Fabre, Jean Michel
N1 - Publisher Copyright:
© 2019 Elsevier Masson SAS
PY - 2020/6
Y1 - 2020/6
N2 - Aim: The aim of this study was to evaluate the new World Health Organization (WHO) 2017 grading system and the others clinicopathological factors in pancreatic neuroendocrine tumor (panNET) operated patients. Methods: Histological staging was based on the WHO 2017 grading system. Outcome after surgery and predictors of overall survival (OS) and disease free survival (DFS) were evaluated. Results: A total of 138 patients underwent surgical resection with a severe morbidity and mortality rates of 14.5% and 0.7% respectively. Five years OS differed according to WHO 2017: 95% among 58 patients with NETG1, 82% in 68 patients with NETG2, 35% in 7 patients with NETG3 and 0% in 5 patients with NECG3 (P < 0.0001). Independent predictors of worse OS were age > 60 y.o (P = 0.014), synchronous metastasis (P = 0.005) and WHO 2017 with significant differences between NETG1 versus NETG2 (P = 0.005), NETG3 (P < 0.001) and NECG3 (P < 0.001). Independent predictors of worse DFS were symptomatic NET (P = 0.038), pN+ status (P = 0.027) and WHO 2017 with significant differences between NETG1 versus NETG3 (P = 0.014) and NECG3 (P = 0.009). Conclusion: The WHO 2017 grading system is a useful tool for patient prognosis after panNET resection and the tailoring of therapeutic strategy. Surgery could provide good results in NETG3 patients.
AB - Aim: The aim of this study was to evaluate the new World Health Organization (WHO) 2017 grading system and the others clinicopathological factors in pancreatic neuroendocrine tumor (panNET) operated patients. Methods: Histological staging was based on the WHO 2017 grading system. Outcome after surgery and predictors of overall survival (OS) and disease free survival (DFS) were evaluated. Results: A total of 138 patients underwent surgical resection with a severe morbidity and mortality rates of 14.5% and 0.7% respectively. Five years OS differed according to WHO 2017: 95% among 58 patients with NETG1, 82% in 68 patients with NETG2, 35% in 7 patients with NETG3 and 0% in 5 patients with NECG3 (P < 0.0001). Independent predictors of worse OS were age > 60 y.o (P = 0.014), synchronous metastasis (P = 0.005) and WHO 2017 with significant differences between NETG1 versus NETG2 (P = 0.005), NETG3 (P < 0.001) and NECG3 (P < 0.001). Independent predictors of worse DFS were symptomatic NET (P = 0.038), pN+ status (P = 0.027) and WHO 2017 with significant differences between NETG1 versus NETG3 (P = 0.014) and NECG3 (P = 0.009). Conclusion: The WHO 2017 grading system is a useful tool for patient prognosis after panNET resection and the tailoring of therapeutic strategy. Surgery could provide good results in NETG3 patients.
KW - Neuroendocrine tumor
KW - Pancreas
KW - Pancreatectomy
KW - Postoperative outcome
KW - Surgery
UR - https://www.scopus.com/pages/publications/85072301587
U2 - 10.1016/j.clinre.2019.08.010
DO - 10.1016/j.clinre.2019.08.010
M3 - Article
SN - 2210-7401
VL - 44
SP - 286
EP - 294
JO - Clinics and Research in Hepatology and Gastroenterology
JF - Clinics and Research in Hepatology and Gastroenterology
IS - 3
ER -