Frontiers in Endocrinology (Aug 2022)
A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival
- 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
Affiliations
- Wu-Hu Zhang
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Wu-Hu Zhang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Wu-Hu Zhang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Wu-Hu Zhang
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Wu-Hu Zhang
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- He-Li Gao
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- He-Li Gao
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- He-Li Gao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- He-Li Gao
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- He-Li Gao
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Wen-Sheng Liu
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Wen-Sheng Liu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Wen-Sheng Liu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Wen-Sheng Liu
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Wen-Sheng Liu
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Yi Qin
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Yi Qin
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Yi Qin
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Yi Qin
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Yi Qin
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Zeng Ye
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Zeng Ye
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Zeng Ye
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Zeng Ye
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Zeng Ye
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Xin Lou
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Xin Lou
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Xin Lou
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Xin Lou
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Xin Lou
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Fei Wang
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Fei Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Fei Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Fei Wang
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Fei Wang
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Yue Zhang
- The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Xue-Min Chen
- The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Jie Chen
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Jie Chen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Jie Chen
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Jie Chen
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Xian-Jun Yu
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Xian-Jun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Xian-Jun Yu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Xian-Jun Yu
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Xian-Jun Yu
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Qi-Feng Zhuo
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Qi-Feng Zhuo
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Qi-Feng Zhuo
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Qi-Feng Zhuo
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Qi-Feng Zhuo
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Xiao-Wu Xu
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Xiao-Wu Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Xiao-Wu Xu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Xiao-Wu Xu
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Xiao-Wu Xu
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Shun-Rong Ji
- Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
- Shun-Rong Ji
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Shun-Rong Ji
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shun-Rong Ji
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Shun-Rong Ji
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- DOI
- https://doi.org/10.3389/fendo.2022.941210
- Journal volume & issue
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Vol. 13
Abstract
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.
Keywords
- pancreatic neuroendocrine tumors
- Ki67 index variation
- grade increase
- preoperative neoadjuvant treatment
- prognosis
