A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study
<i>Background:</i> Oncological survival after resection of pancreatic neuroendocrine neoplasms (panNEN) is highly variable depending on various factors. Risk stratification with preoperatively available parameters could guide decision-making in multidisciplinary treatment concepts. C-rea...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-05-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/5/1235 |
| _version_ | 1797568059766996992 |
|---|---|
| author | Florian Primavesi Valentina Andreasi Frederik J.H. Hoogwater Stefano Partelli Dominik Wiese Charlotte Heidsma Benno Cardini Eckhard Klieser Katharina Marsoner Uwe Fröschl Sabine Thalhammer Ines Fischer Georg Göbel Andreas Hauer Tobias Kiesslich Philipp Ellmerer Reinhold Klug Daniel Neureiter Helwig Wundsam Franz Sellner Peter Kornprat Reinhold Függer Dietmar Öfner Elisabeth J.M. Nieveen van Dijkum Detlef K. Bartsch Ruben H.J. de Kleine Massimo Falconi Stefan Stättner |
| author_facet | Florian Primavesi Valentina Andreasi Frederik J.H. Hoogwater Stefano Partelli Dominik Wiese Charlotte Heidsma Benno Cardini Eckhard Klieser Katharina Marsoner Uwe Fröschl Sabine Thalhammer Ines Fischer Georg Göbel Andreas Hauer Tobias Kiesslich Philipp Ellmerer Reinhold Klug Daniel Neureiter Helwig Wundsam Franz Sellner Peter Kornprat Reinhold Függer Dietmar Öfner Elisabeth J.M. Nieveen van Dijkum Detlef K. Bartsch Ruben H.J. de Kleine Massimo Falconi Stefan Stättner |
| author_sort | Florian Primavesi |
| collection | DOAJ |
| description | <i>Background:</i> Oncological survival after resection of pancreatic neuroendocrine neoplasms (panNEN) is highly variable depending on various factors. Risk stratification with preoperatively available parameters could guide decision-making in multidisciplinary treatment concepts. C-reactive Protein (CRP) is linked to inferior survival in several malignancies. This study assesses CRP within a novel risk score predicting histology and outcome after surgery for sporadic non-functional panNENs. <i>Methods:</i> A retrospective multicenter study with national exploration and international validation. CRP and other factors associated with overall survival (OS) were evaluated by multivariable cox-regression to create a clinical risk score (CRS). Predictive values regarding OS, disease-specific survival (DSS), and recurrence-free survival (RFS) were assessed by time-dependent receiver-operating characteristics. <i>Results:</i> Overall, 364 patients were included. Median CRP was significantly higher in patients >60 years, G3, and large tumors. In multivariable analysis, CRP was the strongest preoperative factor for OS in both cohorts. In the combined cohort, CRP (cut-off ≥0.2 mg/dL; hazard-ratio (HR):3.87), metastases (HR:2.80), and primary tumor size ≥3.0 cm (HR:1.83) showed a significant association with OS. A CRS incorporating these variables was associated with postoperative histological grading, T category, nodal positivity, and 90-day morbidity/mortality. Time-dependent area-under-the-curve at 60 months for OS, DSS, and RFS was 69%, 77%, and 67%, respectively (all <i>p</i> < 0.001), and the inclusion of grading further improved the predictive potential (75%, 84%, and 78%, respectively). <i>Conclusions:</i> CRP is a significant marker of unfavorable oncological characteristics in panNENs. The proposed internationally validated CRS predicts histological features and patient survival. |
| first_indexed | 2024-03-10T19:51:00Z |
| format | Article |
| id | doaj.art-e0f5badea6154b6bb7398c730961093a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T19:51:00Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e0f5badea6154b6bb7398c730961093a2023-11-20T00:27:16ZengMDPI AGCancers2072-66942020-05-01125123510.3390/cancers12051235A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort StudyFlorian Primavesi0Valentina Andreasi1Frederik J.H. Hoogwater2Stefano Partelli3Dominik Wiese4Charlotte Heidsma5Benno Cardini6Eckhard Klieser7Katharina Marsoner8Uwe Fröschl9Sabine Thalhammer10Ines Fischer11Georg Göbel12Andreas Hauer13Tobias Kiesslich14Philipp Ellmerer15Reinhold Klug16Daniel Neureiter17Helwig Wundsam18Franz Sellner19Peter Kornprat20Reinhold Függer21Dietmar Öfner22Elisabeth J.M. Nieveen van Dijkum23Detlef K. Bartsch24Ruben H.J. de Kleine25Massimo Falconi26Stefan Stättner27Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaPancreatic Surgery, Università Vita-Salute, IRCCS Hospital San Raffaele, 20132 Milan, ItalyDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsPancreatic Surgery, Università Vita-Salute, IRCCS Hospital San Raffaele, 20132 Milan, ItalyDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Marburg, 35043 Marburg, GermanyDepartment of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaInstitute of Pathology, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Surgery, Medical University Graz, 8036 Graz, AustriaDepartment of Surgery, Ordensklinikum, 4010 Linz, AustriaDepartment of Surgery, Kaiser Franz Josef Hospital, 1100 Vienna, AustriaDepartment of Surgery, Ordensklinikum, 4010 Linz, AustriaDepartment of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Surgery, General Hospital Horn, 3580 Horn, AustriaInstitute of Physiology and Pathophysiology, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Neurology, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Surgery, General Hospital Horn, 3580 Horn, AustriaInstitute of Pathology, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Surgery, Ordensklinikum, 4010 Linz, AustriaDepartment of Surgery, Kaiser Franz Josef Hospital, 1100 Vienna, AustriaDepartment of Surgery, Medical University Graz, 8036 Graz, AustriaDepartment of Surgery, Ordensklinikum, 4010 Linz, AustriaDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Marburg, 35043 Marburg, GermanyDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsPancreatic Surgery, Università Vita-Salute, IRCCS Hospital San Raffaele, 20132 Milan, ItalyDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria<i>Background:</i> Oncological survival after resection of pancreatic neuroendocrine neoplasms (panNEN) is highly variable depending on various factors. Risk stratification with preoperatively available parameters could guide decision-making in multidisciplinary treatment concepts. C-reactive Protein (CRP) is linked to inferior survival in several malignancies. This study assesses CRP within a novel risk score predicting histology and outcome after surgery for sporadic non-functional panNENs. <i>Methods:</i> A retrospective multicenter study with national exploration and international validation. CRP and other factors associated with overall survival (OS) were evaluated by multivariable cox-regression to create a clinical risk score (CRS). Predictive values regarding OS, disease-specific survival (DSS), and recurrence-free survival (RFS) were assessed by time-dependent receiver-operating characteristics. <i>Results:</i> Overall, 364 patients were included. Median CRP was significantly higher in patients >60 years, G3, and large tumors. In multivariable analysis, CRP was the strongest preoperative factor for OS in both cohorts. In the combined cohort, CRP (cut-off ≥0.2 mg/dL; hazard-ratio (HR):3.87), metastases (HR:2.80), and primary tumor size ≥3.0 cm (HR:1.83) showed a significant association with OS. A CRS incorporating these variables was associated with postoperative histological grading, T category, nodal positivity, and 90-day morbidity/mortality. Time-dependent area-under-the-curve at 60 months for OS, DSS, and RFS was 69%, 77%, and 67%, respectively (all <i>p</i> < 0.001), and the inclusion of grading further improved the predictive potential (75%, 84%, and 78%, respectively). <i>Conclusions:</i> CRP is a significant marker of unfavorable oncological characteristics in panNENs. The proposed internationally validated CRS predicts histological features and patient survival.https://www.mdpi.com/2072-6694/12/5/1235pancreatic neuroendocrine tumorsC-reactive proteinrisk scoreneuroendocrine neoplasmspancreassurgery |
| spellingShingle | Florian Primavesi Valentina Andreasi Frederik J.H. Hoogwater Stefano Partelli Dominik Wiese Charlotte Heidsma Benno Cardini Eckhard Klieser Katharina Marsoner Uwe Fröschl Sabine Thalhammer Ines Fischer Georg Göbel Andreas Hauer Tobias Kiesslich Philipp Ellmerer Reinhold Klug Daniel Neureiter Helwig Wundsam Franz Sellner Peter Kornprat Reinhold Függer Dietmar Öfner Elisabeth J.M. Nieveen van Dijkum Detlef K. Bartsch Ruben H.J. de Kleine Massimo Falconi Stefan Stättner A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study Cancers pancreatic neuroendocrine tumors C-reactive protein risk score neuroendocrine neoplasms pancreas surgery |
| title | A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study |
| title_full | A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study |
| title_fullStr | A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study |
| title_full_unstemmed | A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study |
| title_short | A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms: An International Multicenter Cohort Study |
| title_sort | preoperative clinical risk score including c reactive protein predicts histological tumor characteristics and patient survival after surgery for sporadic non functional pancreatic neuroendocrine neoplasms an international multicenter cohort study |
| topic | pancreatic neuroendocrine tumors C-reactive protein risk score neuroendocrine neoplasms pancreas surgery |
| url | https://www.mdpi.com/2072-6694/12/5/1235 |
| work_keys_str_mv | AT florianprimavesi apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT valentinaandreasi apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT frederikjhhoogwater apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT stefanopartelli apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT dominikwiese apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT charlotteheidsma apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT bennocardini apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT eckhardklieser apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT katharinamarsoner apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT uwefroschl apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT sabinethalhammer apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT inesfischer apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT georggobel apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT andreashauer apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT tobiaskiesslich apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT philippellmerer apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT reinholdklug apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT danielneureiter apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT helwigwundsam apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT franzsellner apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT peterkornprat apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT reinholdfugger apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT dietmarofner apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT elisabethjmnieveenvandijkum apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT detlefkbartsch apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT rubenhjdekleine apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT massimofalconi apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT stefanstattner apreoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT florianprimavesi preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT valentinaandreasi preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT frederikjhhoogwater preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT stefanopartelli preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT dominikwiese preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT charlotteheidsma preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT bennocardini preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT eckhardklieser preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT katharinamarsoner preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT uwefroschl preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT sabinethalhammer preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT inesfischer preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT georggobel preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT andreashauer preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT tobiaskiesslich preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT philippellmerer preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT reinholdklug preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT danielneureiter preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT helwigwundsam preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT franzsellner preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT peterkornprat preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT reinholdfugger preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT dietmarofner preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT elisabethjmnieveenvandijkum preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT detlefkbartsch preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT rubenhjdekleine preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT massimofalconi preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy AT stefanstattner preoperativeclinicalriskscoreincludingcreactiveproteinpredictshistologicaltumorcharacteristicsandpatientsurvivalaftersurgeryforsporadicnonfunctionalpancreaticneuroendocrineneoplasmsaninternationalmulticentercohortstudy |