TY - JOUR
T1 - New staging classification for pancreatic neuroendocrine neoplasms combining TNM stage and WHO grade classification [1]
AU - Minimally Invasive Pancreas Treatment Group in the Pancreatic Disease Branch of China's International Exchange and Promotion Association for Medicine and Healthcare
AU - Wang, Min
AU - Ding, Ding
AU - Qin, Tingting
AU - Wang, Hebin
AU - Liu, Yahui
AU - Liu, Jianhua
AU - Liu, Jun
AU - Zhang, Hang
AU - Zhao, Junfang
AU - Wu, Chien Hui
AU - Javed, Ammar
AU - Wolfgang, Christopher
AU - Guo, Shiwei
AU - Chen, Qingmin
AU - Zhao, Weihong
AU - Shi, Wei
AU - Zhu, Feng
AU - Guo, Xingjun
AU - Li, Xu
AU - He, Ruizhi
AU - Xu, Simiao
AU - Edil, Barish
AU - Tien, Yu Wen
AU - Jin, Gang
AU - Zheng, Lei
AU - He, Jin
AU - Qin, Renyi
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/10/10
Y1 - 2021/10/10
N2 - AJCC TNM stage and WHO grade (G) are two widely used staging systems to guide clinical management for pancreatic neuroendocrine neoplasms (panNENs), based on clinical staging and pathological grading information, respectively. We proposed to integrate TNM stage and G grade into one staging system (TNMG) and to evaluate its clinical application as a prognostic indicator for panNENs. Accordingly, 5254 patients diagnosed with panNENs were used to evaluate and to validate the applicability of TNMG to panNENs. The predictive accuracy of TNMG system was compared with that of each separate staging/grading system. We found that TNM stage and G grade were independent risk factors for survival in both the Surveillance, Epidemiology, and End Result (SEER) and multicenter series. The interaction effect between TNM stage and G grade was significant. Twelve subgroups combining the TNM stage and G grade were proposed in the TNMG stage, which were classified into five stages TNMG. According to the TNMG staging classification in the SEER series, the estimated median survival for stages I, II, III, IV, and V were 203, 174, 112, 61, and 8 months, respectively. The predictive accuracy of TNMG stage was higher than that of TNM stage and G grade used independently. The TNMG stage classification was more accurate in predicting panNEN patient's prognosis than either the TNM stage or G grade.
AB - AJCC TNM stage and WHO grade (G) are two widely used staging systems to guide clinical management for pancreatic neuroendocrine neoplasms (panNENs), based on clinical staging and pathological grading information, respectively. We proposed to integrate TNM stage and G grade into one staging system (TNMG) and to evaluate its clinical application as a prognostic indicator for panNENs. Accordingly, 5254 patients diagnosed with panNENs were used to evaluate and to validate the applicability of TNMG to panNENs. The predictive accuracy of TNMG system was compared with that of each separate staging/grading system. We found that TNM stage and G grade were independent risk factors for survival in both the Surveillance, Epidemiology, and End Result (SEER) and multicenter series. The interaction effect between TNM stage and G grade was significant. Twelve subgroups combining the TNM stage and G grade were proposed in the TNMG stage, which were classified into five stages TNMG. According to the TNMG staging classification in the SEER series, the estimated median survival for stages I, II, III, IV, and V were 203, 174, 112, 61, and 8 months, respectively. The predictive accuracy of TNMG stage was higher than that of TNM stage and G grade used independently. The TNMG stage classification was more accurate in predicting panNEN patient's prognosis than either the TNM stage or G grade.
KW - Pancreatic neuroendocrine neoplasms
KW - TNM stage
KW - WHO grade
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U2 - 10.1016/j.canlet.2021.07.018
DO - 10.1016/j.canlet.2021.07.018
M3 - Article
C2 - 34271105
AN - SCOPUS:85111028502
SN - 0304-3835
VL - 518
SP - 207
EP - 213
JO - Cancer Letters
JF - Cancer Letters
ER -