Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors
The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated. P...
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| Veröffentlicht in: | Journal of clinical oncology 2011-08, Vol.29 (22), p.3044-3049 |
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| creator | STROSBERG, Jonathan R CHEEMA, Asima WEBER, Jill HAN, Gang COPPOLA, Domenico KVOLS, Larry K |
| description | The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated.
Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications.
We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival.
The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice. |
| doi_str_mv | 10.1200/JCO.2011.35.1817 |
| format | Article |
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Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications.
We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival.
The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2011.35.1817</identifier><identifier>PMID: 21709192</identifier><language>eng</language><publisher>Alexandria, VA: American Society of Clinical Oncology</publisher><subject>Adolescent ; Adult ; Advisory Committees ; Aged ; Aged, 80 and over ; Analysis of Variance ; Biological and medical sciences ; Female ; Gastrinoma - mortality ; Gastrinoma - pathology ; Gastroenterology. Liver. Pancreas. Abdomen ; Glucagonoma - mortality ; Glucagonoma - pathology ; Humans ; Incidental Findings ; Insulinoma - mortality ; Insulinoma - pathology ; Kaplan-Meier Estimate ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Neuroendocrine Tumors - classification ; Neuroendocrine Tumors - mortality ; Neuroendocrine Tumors - pathology ; Pancreatic Neoplasms - classification ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Reproducibility of Results ; Retrospective Studies ; Risk Factors ; Tumors ; United States - epidemiology ; Vipoma - mortality ; Vipoma - pathology</subject><ispartof>Journal of clinical oncology, 2011-08, Vol.29 (22), p.3044-3049</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-c5c6719d445f74e8bceb1d4392790a9dc434063955aab0e7a80f95072576ffe33</citedby><cites>FETCH-LOGICAL-c468t-c5c6719d445f74e8bceb1d4392790a9dc434063955aab0e7a80f95072576ffe33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3729,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24391718$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21709192$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>STROSBERG, Jonathan R</creatorcontrib><creatorcontrib>CHEEMA, Asima</creatorcontrib><creatorcontrib>WEBER, Jill</creatorcontrib><creatorcontrib>HAN, Gang</creatorcontrib><creatorcontrib>COPPOLA, Domenico</creatorcontrib><creatorcontrib>KVOLS, Larry K</creatorcontrib><title>Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated.
Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications.
We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival.
The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Advisory Committees</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Gastrinoma - mortality</subject><subject>Gastrinoma - pathology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Glucagonoma - mortality</subject><subject>Glucagonoma - pathology</subject><subject>Humans</subject><subject>Incidental Findings</subject><subject>Insulinoma - mortality</subject><subject>Insulinoma - pathology</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neuroendocrine Tumors - classification</subject><subject>Neuroendocrine Tumors - mortality</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Pancreatic Neoplasms - classification</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><subject>Vipoma - mortality</subject><subject>Vipoma - pathology</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkT1vFDEQhi0EIkegp0JuENUe_jyvy2gFhChKIhEQneXzji-Odu1ge0Ep8t_xKUeopphnXs08g9BbStaUEfLxbLhcM0Lpmss17al6hlZUMtUpJeVztCKKs472_OcRelXKLSFU9Fy-REeMKqKpZiv0cJXTLqZSg8M_7BTGUO9x8tjii_QbJnwyQw7ORnyWQqx4SPMcagXAKeLBRgcZf6t2F-IOD5MtJfhG19C6PmV81YgMdh9-AUtOEMfkcoiAr5c55fIavfB2KvDmUI_R98-frofT7vzyy9fh5LxzYtPXzkm3UVSPQkivBPRbB1s6Cq6Z0sTq0QkuyIZrKa3dElC2J15LophUG--B82P04TH3LqdfC5Rq5lAcTJONkJZi-p5QrhVhjSSPpMuplAze3OUw23xvKDF756Y5N3vnhkuzd95G3h3Cl-0M49PAP8kNeH8AbHF28rlZCeU_1w6hqr3pacubsLv5EzKYMttparHM3LrEtGHMcCIE_wu_n5gI</recordid><startdate>20110801</startdate><enddate>20110801</enddate><creator>STROSBERG, Jonathan R</creator><creator>CHEEMA, Asima</creator><creator>WEBER, Jill</creator><creator>HAN, Gang</creator><creator>COPPOLA, Domenico</creator><creator>KVOLS, Larry K</creator><general>American Society of Clinical Oncology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110801</creationdate><title>Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors</title><author>STROSBERG, Jonathan R ; CHEEMA, Asima ; WEBER, Jill ; HAN, Gang ; COPPOLA, Domenico ; KVOLS, Larry K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-c5c6719d445f74e8bceb1d4392790a9dc434063955aab0e7a80f95072576ffe33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Advisory Committees</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Gastrinoma - mortality</topic><topic>Gastrinoma - pathology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Glucagonoma - mortality</topic><topic>Glucagonoma - pathology</topic><topic>Humans</topic><topic>Incidental Findings</topic><topic>Insulinoma - mortality</topic><topic>Insulinoma - pathology</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neuroendocrine Tumors - classification</topic><topic>Neuroendocrine Tumors - mortality</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Pancreatic Neoplasms - classification</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><topic>Vipoma - mortality</topic><topic>Vipoma - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STROSBERG, Jonathan R</creatorcontrib><creatorcontrib>CHEEMA, Asima</creatorcontrib><creatorcontrib>WEBER, Jill</creatorcontrib><creatorcontrib>HAN, Gang</creatorcontrib><creatorcontrib>COPPOLA, Domenico</creatorcontrib><creatorcontrib>KVOLS, Larry K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STROSBERG, Jonathan R</au><au>CHEEMA, Asima</au><au>WEBER, Jill</au><au>HAN, Gang</au><au>COPPOLA, Domenico</au><au>KVOLS, Larry K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2011-08-01</date><risdate>2011</risdate><volume>29</volume><issue>22</issue><spage>3044</spage><epage>3049</epage><pages>3044-3049</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated.
Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications.
We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival.
The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice.</abstract><cop>Alexandria, VA</cop><pub>American Society of Clinical Oncology</pub><pmid>21709192</pmid><doi>10.1200/JCO.2011.35.1817</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Advisory Committees Aged Aged, 80 and over Analysis of Variance Biological and medical sciences Female Gastrinoma - mortality Gastrinoma - pathology Gastroenterology. Liver. Pancreas. Abdomen Glucagonoma - mortality Glucagonoma - pathology Humans Incidental Findings Insulinoma - mortality Insulinoma - pathology Kaplan-Meier Estimate Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Neoplasm Staging Neuroendocrine Tumors - classification Neuroendocrine Tumors - mortality Neuroendocrine Tumors - pathology Pancreatic Neoplasms - classification Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Predictive Value of Tests Prognosis Proportional Hazards Models Reproducibility of Results Retrospective Studies Risk Factors Tumors United States - epidemiology Vipoma - mortality Vipoma - pathology |
| title | Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors |
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