Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms: Data from a Large International Cohort Study.

Détails

Ressource 1Télécharger: 30300897_pp_cover.pdf (2902.78 [Ko])
Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_24842B90D697
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms: Data from a Large International Cohort Study.
Périodique
Neuroendocrinology
Auteur(s)
Rindi G., Klersy C., Albarello L., Baudin E., Bianchi A., Buchler M.W., Caplin M., Couvelard A., Cros J., de Herder W.W., Delle Fave G., Doglioni C., Federspiel B., Fischer L., Fusai G., Gavazzi F., Hansen C.P., Inzani F., Jann H., Komminoth P., Knigge U.P., Landoni L., La Rosa S., Lawlor R.T., Luong T.V., Marinoni I., Panzuto F., Pape U.F., Partelli S., Perren A., Rinzivillo M., Rubini C., Ruszniewski P., Scarpa A., Schmitt A., Schinzari G., Scoazec J.Y., Sessa F., Solcia E., Spaggiari P., Toumpanakis C., Vanoli A., Wiedenmann B., Zamboni G., Zandee W.T., Zerbi A., Falconi M.
ISSN
1423-0194 (Electronic)
ISSN-L
0028-3835
Statut éditorial
Publié
Date de publication
2018
Peer-reviewed
Oui
Volume
107
Numéro
4
Pages
375-386
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The World Health Organization (WHO) and the American Joint Cancer Committee (AJCC) modified the grading of pancreatic neuroendocrine neoplasms from a three-tier (WHO-AJCC 2010) to a four-tier system by introducing the novel category of NET G3 (WHO-AJCC 2017).
This study aims at validating the WHO-AJCC 2017 and identifying the most effective grading system.
A total of 2,102 patients were enrolled; entry criteria were: (i) patient underwent surgery; (ii) at least 2 years of follow-up; (iii) observation time up to 2015. Data from 34 variables were collected; grading was assessed and compared for efficacy by statistical means including Kaplan-Meier method, Cox regression analysis, Harrell's C statistics, and Royston's explained variation in univariable and multivariable analyses.
In descriptive analysis, the two grading systems demonstrated statistically significant differences for the major category sex but not for age groups. In Cox regression analysis, both grading systems showed statistically significant differences between grades for OS and EFS; however, no statistically significant difference was observed between the two G3 classes of WHO-AJCC 2017. In multivariable analysis for the two models fitted to compare efficacy, the two grading systems performed equally well with substantially similar optimal discrimination and well-explained variation for both OS and EFS. The WHO-AJCC 2017 grading system retained statistically significant difference between the two G3 classes for OS but not for EFS.
The WHO-AJCC 2017 grading system is at least equally performing as the WHO-AJCC 2010 but allows the successful identification of the most aggressive PanNET subgroup. Grading is confirmed as probably the most powerful tool for predicting patient survival.
Mots-clé
Grading, Neuroendocrine neoplasm, Pancreas, Personalized medicine, Staging, Tailored therapy, WHO
Pubmed
Open Access
Oui
Création de la notice
06/11/2018 11:31
Dernière modification de la notice
20/08/2019 13:02
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