A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors
Background Pancreatic neuroendocrine tumors (PanNETs) are indolent pancreatic tumors derived from neuroendocrine cells in pancreatic islets. To date, reliable predictors for identifying patients at high risk for recurrence after curative cancer resection are lacking. We aimed to determine independen...
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| Veröffentlicht in: | Journal of gastroenterology 2021-04, Vol.56 (4), p.395-405 |
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| creator | Wang, Wen-Quan Zhang, Wu-Hu Gao, He-Li Huang, Dan Xu, Hua-Xiang Li, Shuo Li, Tian-Jiao Xu, Shuai-Shuai Li, Hao Long, Jiang Ye, Long-Yun Wu, Chun-Tao Han, Xuan Wang, Xiao-Hong Liu, Liang Yu, Xian-Jun |
| description | Background
Pancreatic neuroendocrine tumors (PanNETs) are indolent pancreatic tumors derived from neuroendocrine cells in pancreatic islets. To date, reliable predictors for identifying patients at high risk for recurrence after curative cancer resection are lacking. We aimed to determine independent predictors for high-risk PanNETs and patient outcomes after surgery.
Methods
We analyzed relevant clinicopathological parameters in 319 consecutive patients of derivation cohort 1 and 106 patients of validation cohort 2 who underwent pancreatectomy and were diagnosed with PanNETs. Association of tumor characteristics with recurrence-free survival (RFS) and overall survival (OS) was evaluated using Cox regression.
Results
PanNET grade 3 (G3), pancreatic duct dilatation, and perineural invasion were independent prognostic factors for RFS and were significantly associated with early recurrence (within 1.5 years) of PanNETs after curative resection (
P
= 0.019,
P
|
| doi_str_mv | 10.1007/s00535-021-01777-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2503447763</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714582909</galeid><sourcerecordid>A714582909</sourcerecordid><originalsourceid>FETCH-LOGICAL-c466t-d06f87bed5f28372e410ed619ba87851438d510bf0eb97158afe23a534f2516c3</originalsourceid><addsrcrecordid>eNp9kc2L1TAUxYMoznP0H3AhBTduOt58Ne3yMfgFA250HdP0ZsjYJs-bVpj_3jzfOKKIZBFy8zuHczmMPedwwQHM6wKgpW5B8Ba4MaaFB2zHVR3pQYiHbAeDUi3nRp2xJ6XcAHAJun_MzqQ0Sggtd-zLvkn5O84NxfK1Cc6vmZqDS3VyIJyiX0uDjubbhtBvRJg8NjHVV0G_4nRkPaFbo28SbpQxTdlTTNis25KpPGWPgpsLPru7z9nnt28-Xb5vrz6--3C5v2q96rq1naALvRlx0kH00ghUHHDq-DC63vS6btVPmsMYAMfBcN27gEI6LVUQmndenrNXJ98D5W8bltUusXic57pL3ooVGqRSxnSyoi__Qm_yRqmmO1Id59rUDPfUtZvRxhTySs4fTe3ecKV7McBQqYt_UPVMuESfE4ZY538IxEngKZdCGOyB4uLo1nKwx1rtqVZba7U_a7VQRS_uEm_jgtO95FePFZAnoNSvdI30e6X_2P4ApiurpA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2506115728</pqid></control><display><type>article</type><title>A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors</title><source>SpringerLink Journals - AutoHoldings</source><creator>Wang, Wen-Quan ; Zhang, Wu-Hu ; Gao, He-Li ; Huang, Dan ; Xu, Hua-Xiang ; Li, Shuo ; Li, Tian-Jiao ; Xu, Shuai-Shuai ; Li, Hao ; Long, Jiang ; Ye, Long-Yun ; Wu, Chun-Tao ; Han, Xuan ; Wang, Xiao-Hong ; Liu, Liang ; Yu, Xian-Jun</creator><creatorcontrib>Wang, Wen-Quan ; Zhang, Wu-Hu ; Gao, He-Li ; Huang, Dan ; Xu, Hua-Xiang ; Li, Shuo ; Li, Tian-Jiao ; Xu, Shuai-Shuai ; Li, Hao ; Long, Jiang ; Ye, Long-Yun ; Wu, Chun-Tao ; Han, Xuan ; Wang, Xiao-Hong ; Liu, Liang ; Yu, Xian-Jun</creatorcontrib><description>Background
Pancreatic neuroendocrine tumors (PanNETs) are indolent pancreatic tumors derived from neuroendocrine cells in pancreatic islets. To date, reliable predictors for identifying patients at high risk for recurrence after curative cancer resection are lacking. We aimed to determine independent predictors for high-risk PanNETs and patient outcomes after surgery.
Methods
We analyzed relevant clinicopathological parameters in 319 consecutive patients of derivation cohort 1 and 106 patients of validation cohort 2 who underwent pancreatectomy and were diagnosed with PanNETs. Association of tumor characteristics with recurrence-free survival (RFS) and overall survival (OS) was evaluated using Cox regression.
Results
PanNET grade 3 (G3), pancreatic duct dilatation, and perineural invasion were independent prognostic factors for RFS and were significantly associated with early recurrence (within 1.5 years) of PanNETs after curative resection (
P
= 0.019,
P
< 0.001, and
P
< 0.001, respectively). Using these factors, we established a novel risk factor panel (R-panel), which predicted early recurrence (
P
< 0.001, HR = 15.02, 95% CI 5.76–39.19). Predictive accuracy of this R-panel was favorable, with a C-index of 0.853, higher than AJCC TNM staging (0.713). We further built an integrated staging system combining R-panel scoring and TNM staging, which improved predictive probability of TNM staging. Finally, we showed that adjuvant therapy with long-acting somatostatin analogs (SSAs) significantly reduced postoperative recurrence (
P
< 0.001) and prolonged long-term survival (
P
= 0.021) in patients with the above risk factors.
Conclusion
We identified a novel risk factor panel, which includes PanNET G3, pancreatic duct dilatation, and perineural invasion; this panel predicted early recurrence of PanNETs after curative resection. Patients with these risk factors can benefit from adjuvant therapy with SSAs.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-021-01777-0</identifier><identifier>PMID: 33742253</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Biliary Tract ; Colorectal Surgery ; Diseases ; Gastroenterology ; Health aspects ; Hepatology ; Medical prognosis ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Neuroendocrine tumors ; Original Article—Liver ; Pancreas ; Pancreatic cancer ; Prognosis ; Relapse ; Risk factors ; Somatostatin ; Surgery ; Surgical Oncology ; Tumor staging</subject><ispartof>Journal of gastroenterology, 2021-04, Vol.56 (4), p.395-405</ispartof><rights>Japanese Society of Gastroenterology 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Japanese Society of Gastroenterology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-d06f87bed5f28372e410ed619ba87851438d510bf0eb97158afe23a534f2516c3</citedby><cites>FETCH-LOGICAL-c466t-d06f87bed5f28372e410ed619ba87851438d510bf0eb97158afe23a534f2516c3</cites><orcidid>0000-0002-6697-7143</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-021-01777-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-021-01777-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33742253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Wen-Quan</creatorcontrib><creatorcontrib>Zhang, Wu-Hu</creatorcontrib><creatorcontrib>Gao, He-Li</creatorcontrib><creatorcontrib>Huang, Dan</creatorcontrib><creatorcontrib>Xu, Hua-Xiang</creatorcontrib><creatorcontrib>Li, Shuo</creatorcontrib><creatorcontrib>Li, Tian-Jiao</creatorcontrib><creatorcontrib>Xu, Shuai-Shuai</creatorcontrib><creatorcontrib>Li, Hao</creatorcontrib><creatorcontrib>Long, Jiang</creatorcontrib><creatorcontrib>Ye, Long-Yun</creatorcontrib><creatorcontrib>Wu, Chun-Tao</creatorcontrib><creatorcontrib>Han, Xuan</creatorcontrib><creatorcontrib>Wang, Xiao-Hong</creatorcontrib><creatorcontrib>Liu, Liang</creatorcontrib><creatorcontrib>Yu, Xian-Jun</creatorcontrib><title>A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Pancreatic neuroendocrine tumors (PanNETs) are indolent pancreatic tumors derived from neuroendocrine cells in pancreatic islets. To date, reliable predictors for identifying patients at high risk for recurrence after curative cancer resection are lacking. We aimed to determine independent predictors for high-risk PanNETs and patient outcomes after surgery.
Methods
We analyzed relevant clinicopathological parameters in 319 consecutive patients of derivation cohort 1 and 106 patients of validation cohort 2 who underwent pancreatectomy and were diagnosed with PanNETs. Association of tumor characteristics with recurrence-free survival (RFS) and overall survival (OS) was evaluated using Cox regression.
Results
PanNET grade 3 (G3), pancreatic duct dilatation, and perineural invasion were independent prognostic factors for RFS and were significantly associated with early recurrence (within 1.5 years) of PanNETs after curative resection (
P
= 0.019,
P
< 0.001, and
P
< 0.001, respectively). Using these factors, we established a novel risk factor panel (R-panel), which predicted early recurrence (
P
< 0.001, HR = 15.02, 95% CI 5.76–39.19). Predictive accuracy of this R-panel was favorable, with a C-index of 0.853, higher than AJCC TNM staging (0.713). We further built an integrated staging system combining R-panel scoring and TNM staging, which improved predictive probability of TNM staging. Finally, we showed that adjuvant therapy with long-acting somatostatin analogs (SSAs) significantly reduced postoperative recurrence (
P
< 0.001) and prolonged long-term survival (
P
= 0.021) in patients with the above risk factors.
Conclusion
We identified a novel risk factor panel, which includes PanNET G3, pancreatic duct dilatation, and perineural invasion; this panel predicted early recurrence of PanNETs after curative resection. Patients with these risk factors can benefit from adjuvant therapy with SSAs.</description><subject>Abdominal Surgery</subject><subject>Biliary Tract</subject><subject>Colorectal Surgery</subject><subject>Diseases</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Neuroendocrine tumors</subject><subject>Original Article—Liver</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Prognosis</subject><subject>Relapse</subject><subject>Risk factors</subject><subject>Somatostatin</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Tumor staging</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc2L1TAUxYMoznP0H3AhBTduOt58Ne3yMfgFA250HdP0ZsjYJs-bVpj_3jzfOKKIZBFy8zuHczmMPedwwQHM6wKgpW5B8Ba4MaaFB2zHVR3pQYiHbAeDUi3nRp2xJ6XcAHAJun_MzqQ0Sggtd-zLvkn5O84NxfK1Cc6vmZqDS3VyIJyiX0uDjubbhtBvRJg8NjHVV0G_4nRkPaFbo28SbpQxTdlTTNis25KpPGWPgpsLPru7z9nnt28-Xb5vrz6--3C5v2q96rq1naALvRlx0kH00ghUHHDq-DC63vS6btVPmsMYAMfBcN27gEI6LVUQmndenrNXJ98D5W8bltUusXic57pL3ooVGqRSxnSyoi__Qm_yRqmmO1Id59rUDPfUtZvRxhTySs4fTe3ecKV7McBQqYt_UPVMuESfE4ZY538IxEngKZdCGOyB4uLo1nKwx1rtqVZba7U_a7VQRS_uEm_jgtO95FePFZAnoNSvdI30e6X_2P4ApiurpA</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Wang, Wen-Quan</creator><creator>Zhang, Wu-Hu</creator><creator>Gao, He-Li</creator><creator>Huang, Dan</creator><creator>Xu, Hua-Xiang</creator><creator>Li, Shuo</creator><creator>Li, Tian-Jiao</creator><creator>Xu, Shuai-Shuai</creator><creator>Li, Hao</creator><creator>Long, Jiang</creator><creator>Ye, Long-Yun</creator><creator>Wu, Chun-Tao</creator><creator>Han, Xuan</creator><creator>Wang, Xiao-Hong</creator><creator>Liu, Liang</creator><creator>Yu, Xian-Jun</creator><general>Springer Singapore</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6697-7143</orcidid></search><sort><creationdate>20210401</creationdate><title>A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors</title><author>Wang, Wen-Quan ; Zhang, Wu-Hu ; Gao, He-Li ; Huang, Dan ; Xu, Hua-Xiang ; Li, Shuo ; Li, Tian-Jiao ; Xu, Shuai-Shuai ; Li, Hao ; Long, Jiang ; Ye, Long-Yun ; Wu, Chun-Tao ; Han, Xuan ; Wang, Xiao-Hong ; Liu, Liang ; Yu, Xian-Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-d06f87bed5f28372e410ed619ba87851438d510bf0eb97158afe23a534f2516c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Biliary Tract</topic><topic>Colorectal Surgery</topic><topic>Diseases</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Neuroendocrine tumors</topic><topic>Original Article—Liver</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Prognosis</topic><topic>Relapse</topic><topic>Risk factors</topic><topic>Somatostatin</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Tumor staging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Wen-Quan</creatorcontrib><creatorcontrib>Zhang, Wu-Hu</creatorcontrib><creatorcontrib>Gao, He-Li</creatorcontrib><creatorcontrib>Huang, Dan</creatorcontrib><creatorcontrib>Xu, Hua-Xiang</creatorcontrib><creatorcontrib>Li, Shuo</creatorcontrib><creatorcontrib>Li, Tian-Jiao</creatorcontrib><creatorcontrib>Xu, Shuai-Shuai</creatorcontrib><creatorcontrib>Li, Hao</creatorcontrib><creatorcontrib>Long, Jiang</creatorcontrib><creatorcontrib>Ye, Long-Yun</creatorcontrib><creatorcontrib>Wu, Chun-Tao</creatorcontrib><creatorcontrib>Han, Xuan</creatorcontrib><creatorcontrib>Wang, Xiao-Hong</creatorcontrib><creatorcontrib>Liu, Liang</creatorcontrib><creatorcontrib>Yu, Xian-Jun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Wen-Quan</au><au>Zhang, Wu-Hu</au><au>Gao, He-Li</au><au>Huang, Dan</au><au>Xu, Hua-Xiang</au><au>Li, Shuo</au><au>Li, Tian-Jiao</au><au>Xu, Shuai-Shuai</au><au>Li, Hao</au><au>Long, Jiang</au><au>Ye, Long-Yun</au><au>Wu, Chun-Tao</au><au>Han, Xuan</au><au>Wang, Xiao-Hong</au><au>Liu, Liang</au><au>Yu, Xian-Jun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>56</volume><issue>4</issue><spage>395</spage><epage>405</epage><pages>395-405</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
Pancreatic neuroendocrine tumors (PanNETs) are indolent pancreatic tumors derived from neuroendocrine cells in pancreatic islets. To date, reliable predictors for identifying patients at high risk for recurrence after curative cancer resection are lacking. We aimed to determine independent predictors for high-risk PanNETs and patient outcomes after surgery.
Methods
We analyzed relevant clinicopathological parameters in 319 consecutive patients of derivation cohort 1 and 106 patients of validation cohort 2 who underwent pancreatectomy and were diagnosed with PanNETs. Association of tumor characteristics with recurrence-free survival (RFS) and overall survival (OS) was evaluated using Cox regression.
Results
PanNET grade 3 (G3), pancreatic duct dilatation, and perineural invasion were independent prognostic factors for RFS and were significantly associated with early recurrence (within 1.5 years) of PanNETs after curative resection (
P
= 0.019,
P
< 0.001, and
P
< 0.001, respectively). Using these factors, we established a novel risk factor panel (R-panel), which predicted early recurrence (
P
< 0.001, HR = 15.02, 95% CI 5.76–39.19). Predictive accuracy of this R-panel was favorable, with a C-index of 0.853, higher than AJCC TNM staging (0.713). We further built an integrated staging system combining R-panel scoring and TNM staging, which improved predictive probability of TNM staging. Finally, we showed that adjuvant therapy with long-acting somatostatin analogs (SSAs) significantly reduced postoperative recurrence (
P
< 0.001) and prolonged long-term survival (
P
= 0.021) in patients with the above risk factors.
Conclusion
We identified a novel risk factor panel, which includes PanNET G3, pancreatic duct dilatation, and perineural invasion; this panel predicted early recurrence of PanNETs after curative resection. Patients with these risk factors can benefit from adjuvant therapy with SSAs.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>33742253</pmid><doi>10.1007/s00535-021-01777-0</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6697-7143</orcidid></addata></record> |
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| ispartof | Journal of gastroenterology, 2021-04, Vol.56 (4), p.395-405 |
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| subjects | Abdominal Surgery Biliary Tract Colorectal Surgery Diseases Gastroenterology Health aspects Hepatology Medical prognosis Medical research Medicine Medicine & Public Health Medicine, Experimental Neuroendocrine tumors Original Article—Liver Pancreas Pancreatic cancer Prognosis Relapse Risk factors Somatostatin Surgery Surgical Oncology Tumor staging |
| title | A novel risk factor panel predicts early recurrence in resected pancreatic neuroendocrine tumors |
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