A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival
BackgroundTumor grade determined by the Ki67 index is the best prognostic factor for pancreatic neuroendocrine tumors (PanNETs). However, we often observe that the grade of metastases differs from that of their primary tumors. This study aimed to investigate the frequency of grade changes between pr...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.941210/full |
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| author | Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang He-Li Gao He-Li Gao He-Li Gao He-Li Gao He-Li Gao Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Yi Qin Yi Qin Yi Qin Yi Qin Yi Qin Zeng Ye Zeng Ye Zeng Ye Zeng Ye Zeng Ye Xin Lou Xin Lou Xin Lou Xin Lou Xin Lou Fei Wang Fei Wang Fei Wang Fei Wang Fei Wang Yue Zhang Xue-Min Chen Jie Chen Jie Chen Jie Chen Jie Chen Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji |
| author_facet | Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang He-Li Gao He-Li Gao He-Li Gao He-Li Gao He-Li Gao Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Yi Qin Yi Qin Yi Qin Yi Qin Yi Qin Zeng Ye Zeng Ye Zeng Ye Zeng Ye Zeng Ye Xin Lou Xin Lou Xin Lou Xin Lou Xin Lou Fei Wang Fei Wang Fei Wang Fei Wang Fei Wang Yue Zhang Xue-Min Chen Jie Chen Jie Chen Jie Chen Jie Chen Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji |
| author_sort | Wu-Hu Zhang |
| collection | DOAJ |
| description | BackgroundTumor grade determined by the Ki67 index is the best prognostic factor for pancreatic neuroendocrine tumors (PanNETs). However, we often observe that the grade of metastases differs from that of their primary tumors. This study aimed to investigate the frequency of grade changes between primary tumors and metastases, explore its association with clinical characteristics, and correlate the findings with the prognosis.MethodsSix hundred forty-eight patients with pancreatic neuroendocrine neoplasms treated at Fudan University Shanghai Cancer Center were screened for inclusion, and 103 patients with PanNETs who had paired primary tumors and metastases with an available Ki67 index were included. Re-evaluation of Ki67 was performed on 98 available samples from 69 patients.ResultsFifty cases (48.5%) had a Ki67 index variation, and 18 cases (17.5%) displayed a grade increase. Metachronous metastases showed significantly higher Ki67 index variation than synchronous metastases (P=0.028). Kaplan–Meier analyses showed that high-grade metastases compared to low-grade primary tumors were significantly associated with decreased progression-free survival (PFS, P=0.012) and overall survival (OS, P=0.027). Multivariable Cox regression analyses demonstrated that a low-grade increase to high-grade was an unfavorable and independent prognostic factor for PFS and OS (P=0.010, and P=0.041, respectively).ConclusionsA high-grade increase in metastases was an unfavorable predictor of PanNETs, which emphasized the importance of accurate pathological grading and could provide a reference for clinical decision-making. |
| first_indexed | 2024-12-10T20:19:31Z |
| format | Article |
| id | doaj.art-af51066d09e84d11b875bd38671daf5b |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-10T20:19:31Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-af51066d09e84d11b875bd38671daf5b2022-12-22T01:35:06ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.941210941210A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survivalWu-Hu Zhang0Wu-Hu Zhang1Wu-Hu Zhang2Wu-Hu Zhang3Wu-Hu Zhang4He-Li Gao5He-Li Gao6He-Li Gao7He-Li Gao8He-Li Gao9Wen-Sheng Liu10Wen-Sheng Liu11Wen-Sheng Liu12Wen-Sheng Liu13Wen-Sheng Liu14Yi Qin15Yi Qin16Yi Qin17Yi Qin18Yi Qin19Zeng Ye20Zeng Ye21Zeng Ye22Zeng Ye23Zeng Ye24Xin Lou25Xin Lou26Xin Lou27Xin Lou28Xin Lou29Fei Wang30Fei Wang31Fei Wang32Fei Wang33Fei Wang34Yue Zhang35Xue-Min Chen36Jie Chen37Jie Chen38Jie Chen39Jie Chen40Xian-Jun Yu41Xian-Jun Yu42Xian-Jun Yu43Xian-Jun Yu44Xian-Jun Yu45Qi-Feng Zhuo46Qi-Feng Zhuo47Qi-Feng Zhuo48Qi-Feng Zhuo49Qi-Feng Zhuo50Xiao-Wu Xu51Xiao-Wu Xu52Xiao-Wu Xu53Xiao-Wu Xu54Xiao-Wu Xu55Shun-Rong Ji56Shun-Rong Ji57Shun-Rong Ji58Shun-Rong Ji59Shun-Rong Ji60Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaThe First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaThe First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaCenter for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, ChinaPancreatic Cancer Institute, Fudan University, Shanghai, ChinaBackgroundTumor grade determined by the Ki67 index is the best prognostic factor for pancreatic neuroendocrine tumors (PanNETs). However, we often observe that the grade of metastases differs from that of their primary tumors. This study aimed to investigate the frequency of grade changes between primary tumors and metastases, explore its association with clinical characteristics, and correlate the findings with the prognosis.MethodsSix hundred forty-eight patients with pancreatic neuroendocrine neoplasms treated at Fudan University Shanghai Cancer Center were screened for inclusion, and 103 patients with PanNETs who had paired primary tumors and metastases with an available Ki67 index were included. Re-evaluation of Ki67 was performed on 98 available samples from 69 patients.ResultsFifty cases (48.5%) had a Ki67 index variation, and 18 cases (17.5%) displayed a grade increase. Metachronous metastases showed significantly higher Ki67 index variation than synchronous metastases (P=0.028). Kaplan–Meier analyses showed that high-grade metastases compared to low-grade primary tumors were significantly associated with decreased progression-free survival (PFS, P=0.012) and overall survival (OS, P=0.027). Multivariable Cox regression analyses demonstrated that a low-grade increase to high-grade was an unfavorable and independent prognostic factor for PFS and OS (P=0.010, and P=0.041, respectively).ConclusionsA high-grade increase in metastases was an unfavorable predictor of PanNETs, which emphasized the importance of accurate pathological grading and could provide a reference for clinical decision-making.https://www.frontiersin.org/articles/10.3389/fendo.2022.941210/fullpancreatic neuroendocrine tumorsKi67 index variationgrade increasepreoperative neoadjuvant treatmentprognosis |
| spellingShingle | Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang Wu-Hu Zhang He-Li Gao He-Li Gao He-Li Gao He-Li Gao He-Li Gao Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Wen-Sheng Liu Yi Qin Yi Qin Yi Qin Yi Qin Yi Qin Zeng Ye Zeng Ye Zeng Ye Zeng Ye Zeng Ye Xin Lou Xin Lou Xin Lou Xin Lou Xin Lou Fei Wang Fei Wang Fei Wang Fei Wang Fei Wang Yue Zhang Xue-Min Chen Jie Chen Jie Chen Jie Chen Jie Chen Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Xian-Jun Yu Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Qi-Feng Zhuo Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Xiao-Wu Xu Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji Shun-Rong Ji A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival Frontiers in Endocrinology pancreatic neuroendocrine tumors Ki67 index variation grade increase preoperative neoadjuvant treatment prognosis |
| title | A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival |
| title_full | A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival |
| title_fullStr | A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival |
| title_full_unstemmed | A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival |
| title_short | A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival |
| title_sort | real life treatment cohort of pancreatic neuroendocrine tumors high grade increase in metastases confers poor survival |
| topic | pancreatic neuroendocrine tumors Ki67 index variation grade increase preoperative neoadjuvant treatment prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.941210/full |
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reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT xiaowuxu reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT xiaowuxu reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT xiaowuxu reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT xiaowuxu reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT shunrongji reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT shunrongji reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT shunrongji reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT shunrongji reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival AT shunrongji reallifetreatmentcohortofpancreaticneuroendocrinetumorshighgradeincreaseinmetastasesconferspoorsurvival |