Ampullary Neuroendocrine Neoplasms: Identification of Prognostic Factors in a Multicentric Series of 119 Cases.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_9726313135C2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ampullary Neuroendocrine Neoplasms: Identification of Prognostic Factors in a Multicentric Series of 119 Cases.
Journal
Endocrine pathology
Author(s)
Vanoli A., Grami O., Klersy C., Milanetto A.C., Albarello L., Fassan M., Luchini C., Grillo F., Spaggiari P., Inzani F., Uccella S., Parente P., Nappo G., Mattiolo P., Milione M., Pietrabissa A., Cobianchi L., Schiavo Lena M., Partelli S., Di Sabatino A., Sempoux C., Capella C., Pasquali C., Doglioni C., Sessa F., Scarpa A., Rindi G., Paulli M., Zerbi A., Falconi M., Solcia E., La Rosa S.
ISSN
1559-0097 (Electronic)
ISSN-L
1046-3976
Publication state
Published
Issued date
06/2022
Peer-reviewed
Oui
Volume
33
Number
2
Pages
274-288
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Neuroendocrine neoplasms (NENs) of the major and minor ampulla are rare diseases with clinico-pathologic features distinct from non-ampullary-duodenal NENs. However, they have been often combined and the knowledge on prognostic factors specific to ampullary NENs (Amp-NENs) is limited. The aim of this study was to identify factors associated with metastatic potential and patient prognosis in Amp-NENs. We clinically and histologically investigated an international series of 119 Amp-NENs, comprising 93 ampullary neuroendocrine tumors (Amp-NETs) and 26 neuroendocrine carcinomas (Amp-NECs). Somatostatin-producing tubulo-acinar NET represented the predominant Amp-NET histologic subtype (58 cases, 62%, 12 associated with type 1 neurofibromatosis). Compared to Amp-NETs, Amp-NECs arose in significantly older patients and showed a larger tumor size, a more frequent small vessel invasion, a deeper level of invasion and a higher rate of distant metastasis, and, importantly, a tremendously worse disease-specific patient survival. In Amp-NETs, the WHO grade proved to be a strong predictor of disease-specific survival (hazard ratio: 12.61, p < 0.001 for G2 vs G1), as well as patient age at diagnosis > 60 years, small vessel invasion, pancreatic invasion, and distant metastasis at diagnosis. Although nodal metastatic disease was not associated with survival by itself, patients with > 3 metastatic lymph nodes showed a worse outcome in comparison with the remaining Amp-NET cases with lymphadenectomy. Tumor epicenter in the major ampulla, small vessel invasion, and tumor size > 16 mm were independent predictors of nodal metastases in Amp-NETs. In conclusion, we identified prognostic factors, which may eventually help guide treatment decisions in Amp-NENs.
Keywords
Adenosine Monophosphate, Carcinoma, Neuroendocrine/pathology, Humans, Infant, Newborn, Neuroendocrine Tumors/pathology, Pancreatic Neoplasms/pathology, Prognosis, Major ampulla, Minor papilla, Neuroendocrine carcinoma, Neuroendocrine tumor, Tumor grade
Pubmed
Web of science
Open Access
Yes
Create date
16/05/2022 6:50
Last modification date
04/06/2022 6:11
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