Prognostic factors and survival after surgical resection of pancreatic neuroendocrine tumor with validation of established and modified staging systems

作     者：Nikolaos Benetatos James Hodson Ravi Marudanayagam Robert P Sutcliffe John R Isaac John Ayuk Tahir Shah Keith J Roberts 

作者机构：The HPB Unit Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Institute of Translational Medicine Queen Elizabeth Hospital Birmingham University Hospitals Birmingham Endocrinology Queen Elizabeth Hospital Birmingham University Hospitals Birmingham Liver Unit Queen Elizabeth Hospital Birmingham University Hospital of Birmingham NHS Foundation Trust 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2018年第17卷第2期

页      面：169-175页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：approved by the Clinical Audit Department and Clinical Governance of the Queen Elizabeth Hospital University Hospitals of Birmingham, UK 

主　　题：Pancreatic neuroendocrine tumors Prognostic factors Validation of staging systems 

摘      要：Background: Pancreatic neuroendocrine tumors(PNETs) display wide heterogeneity with highly variable prognosis. This study aimed to identify variables related to survival after surgical resection of ***: A total of 143 patients were identified from a prospectively maintained database. Patient characteristics were analyzed and prognostic factors for overall survival and progression-free survival were evaluated. The WHO, ENETS and AJCC scoring systems were applied to the cohort, and their ability to predict patient outcomes were ***: Multivariate analysis found that female gender, lymph node metastases and increasing WHO2010 grade to be independently associated with reduced overall survival(P 0.05). Patients requiring multi-visceral resection or debulking surgery found to be associated with shortest survival. ROC analysis found the ENETS and AJCC scoring systems to be similarly predictive of 5-year overall survival. Modified Ki67 significantly improved its accuracy in predicting 5-year overall survival(AUROC: 0.699 vs 0.605;P 0.01).Conclusions: Multi-visceral or debulking surgery is associated with poor outcomes. There seems to be no significant difference between enucleation and anatomical segmental resection. Available scoring systems have reasonable accuracy in stratifying disease severity, with no system identified as being *** stratification with modified grading systems needs further validation before applied in clinical practice.