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Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma

BACKGROUND: The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) staging classifications are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful tumor–node–metastasis (TNM) staging syst...

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Autores principales: Wang, Haihong, Lin, Zhenyu, Li, Guiling, Zhang, Dejun, Yu, Dandan, Lin, Qili, Wang, Jing, Zhao, Ye, Pi, Guoliang, Zhang, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059325/
https://www.ncbi.nlm.nih.gov/pubmed/32138704
http://dx.doi.org/10.1186/s12885-020-6634-9
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author Wang, Haihong
Lin, Zhenyu
Li, Guiling
Zhang, Dejun
Yu, Dandan
Lin, Qili
Wang, Jing
Zhao, Ye
Pi, Guoliang
Zhang, Tao
author_facet Wang, Haihong
Lin, Zhenyu
Li, Guiling
Zhang, Dejun
Yu, Dandan
Lin, Qili
Wang, Jing
Zhao, Ye
Pi, Guoliang
Zhang, Tao
author_sort Wang, Haihong
collection PubMed
description BACKGROUND: The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) staging classifications are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful tumor–node–metastasis (TNM) staging system for poorly differentiated pancreatic neuroendocrine carcinomas (pNECs). METHODS: An analysis was performed to evaluate the application of the ENETS, 7th edition (7th) AJCC and 8th edition (8th) AJCC staging classifications using the Surveillance, Epidemiology, and End Results (SEER) registry (N = 568 patients), and a modified system based on the analysis of the 7th AJCC classification was proposed. RESULTS: In multivariable analyses, only the 7th AJCC staging system allocated patients into four different risk groups, although there was no significant difference. We modified the staging classification by maintaining the T and M definitions of the 7th AJCC staging and adopting new staging definitions. An increased hazard ratio (HR) of death was also observed from class I to class IV for the modified 7th (m7th) staging system (compared with stage I disease; HR for stage II =1.23, 95% confidence interval (CI) = 0.73–2.06, P = 0.44; HR for stage III =2.20, 95% CI =1.06–4.56, P = 0.03; HR for stage IV =4.95, 95% CI =3.20–7.65, P < 0.001). The concordance index (C-index) was higher for local disease with the m7th AJCC staging system than with the 7th AJCC staging system. CONCLUSIONS: The m7th AJCC staging system for pNECs proposed in this study provides improvements and may be assessed for potential adoption in the next edition.
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spelling pubmed-70593252020-03-12 Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma Wang, Haihong Lin, Zhenyu Li, Guiling Zhang, Dejun Yu, Dandan Lin, Qili Wang, Jing Zhao, Ye Pi, Guoliang Zhang, Tao BMC Cancer Research Article BACKGROUND: The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) staging classifications are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful tumor–node–metastasis (TNM) staging system for poorly differentiated pancreatic neuroendocrine carcinomas (pNECs). METHODS: An analysis was performed to evaluate the application of the ENETS, 7th edition (7th) AJCC and 8th edition (8th) AJCC staging classifications using the Surveillance, Epidemiology, and End Results (SEER) registry (N = 568 patients), and a modified system based on the analysis of the 7th AJCC classification was proposed. RESULTS: In multivariable analyses, only the 7th AJCC staging system allocated patients into four different risk groups, although there was no significant difference. We modified the staging classification by maintaining the T and M definitions of the 7th AJCC staging and adopting new staging definitions. An increased hazard ratio (HR) of death was also observed from class I to class IV for the modified 7th (m7th) staging system (compared with stage I disease; HR for stage II =1.23, 95% confidence interval (CI) = 0.73–2.06, P = 0.44; HR for stage III =2.20, 95% CI =1.06–4.56, P = 0.03; HR for stage IV =4.95, 95% CI =3.20–7.65, P < 0.001). The concordance index (C-index) was higher for local disease with the m7th AJCC staging system than with the 7th AJCC staging system. CONCLUSIONS: The m7th AJCC staging system for pNECs proposed in this study provides improvements and may be assessed for potential adoption in the next edition. BioMed Central 2020-03-06 /pmc/articles/PMC7059325/ /pubmed/32138704 http://dx.doi.org/10.1186/s12885-020-6634-9 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wang, Haihong
Lin, Zhenyu
Li, Guiling
Zhang, Dejun
Yu, Dandan
Lin, Qili
Wang, Jing
Zhao, Ye
Pi, Guoliang
Zhang, Tao
Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title_full Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title_fullStr Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title_full_unstemmed Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title_short Validation and modification of staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma
title_sort validation and modification of staging systems for poorly differentiated pancreatic neuroendocrine carcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059325/
https://www.ncbi.nlm.nih.gov/pubmed/32138704
http://dx.doi.org/10.1186/s12885-020-6634-9
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