Functional and non-functional pancreatic neuroendocrine tumours: ENETS or AJCC TNM staging system?



Yang, Min, Ke, Neng-Wen, Zhang, Yi, Tan, Chun-Lu, Tian, Bo-Le, Liu, Xu-Bao, Huang, Wei, Nunes, Quentin ORCID: 0000-0002-7513-8595 and Sutton, Robert ORCID: 0000-0001-6600-562X
(2017) Functional and non-functional pancreatic neuroendocrine tumours: ENETS or AJCC TNM staging system? ONCOTARGET, 8 (47). pp. 82784-82795.

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Abstract

Background: There are currently 2 Tumour-Node-Metastasis (TNM) staging systems for pancreatic neuroendocrine tumours (p-NETs) - European Neuroendocrine Tumour Society (ENETS) and American Joint Committee on Cancer (AJCC). P-NETs being heterogeneous, we investigated the prognostic value of the 2 systems in p-NETs, as a whole, and more interestingly in functional and non-functional sub-groups separately, with a view to ascertaining any potential clinical benefits of using one system over the other. Methods: Data from patients with surgically resected p-NETs were retrospectively reviewed. Kaplan-Meier method and Cox Regression proportional hazards model were used to analyse overall survival (OS) and prognostic predictors respectively. Results: In the whole group of 165 patients, both TNM systems successfully discriminated OS differences when comparing stages I and II with stages III and IV (P<0.05); ENETS stage III patients had a significantly better OS than those in stage IV (P=0.003). Patients with functional p-NETs in ENETS stage II showed a statistically better OS than those in stages III and IV (P<0.05). For non-functional tumours, the AJCC staging system could effectively discriminate between the OS differences of patients in stage I with stages III and IV, or stage II with III and IV (P<0.05). Along with surgical intent and World Health Organisation (WHO) 2010 grade, both ENETS and AJCC staging systems were effective predictors of OS for different function-status p-NETs. Conclusions: The ENETS system might have potential advantages when applied to all p-NETs and to the functional sub-group, while the AJCC system might be clinically more practical for non-functional p-NETs.

Item Type: Article
Uncontrolled Keywords: pancreatic neuroendocrine tumours, functional status, TNM, ENETS, AJCC
Depositing User: Symplectic Admin
Date Deposited: 23 Jan 2019 15:48
Last Modified: 19 Jan 2023 01:06
DOI: 10.18632/oncotarget.20007
Open Access URL: http://www.oncotarget.com/index.php?journal=oncota...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3031697