Academic Journal
A Consensus-Developed Morphological Re-Evaluation of 196 High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms and Its Clinical Correlations.
| Τίτλος: | A Consensus-Developed Morphological Re-Evaluation of 196 High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms and Its Clinical Correlations. |
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| Συγγραφείς: | Elvebakken H; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway, hege.elvebakken@helse-mr.no.; Department of Oncology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway, hege.elvebakken@helse-mr.no., Perren A; Institute of Pathology, University of Bern, Bern, Switzerland., Scoazec JY; Department of Biopathology, Institut Gustave Roussy, Villejuif, France., Tang LH; Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA., Federspiel B; Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Klimstra DS; Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA., Vestermark LW; Department of Oncology, Odense University Hospital, Odense, Denmark., Ali AS; Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden., Zlobec I; Institute of Pathology, University of Bern, Bern, Switzerland., Myklebust TÅ; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.; Department of Registration, Cancer Registry Norway, Oslo, Norway., Hjortland GO; Department of Oncology, Oslo University Hospital, Oslo, Norway., Langer SW; Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Gronbaek H; Department of Hepatology & Gastroenterology, Aarhus University Hospital & ENETS Center of Excellence, Aarhus, Denmark., Knigge U; Department of Surgery C and Endocrinology PE, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark., Tiensuu Janson E; Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden., Sorbye H; Department of Oncology, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway. |
| Πηγή: | Neuroendocrinology [Neuroendocrinology] 2021; Vol. 111 (9), pp. 883-894. Date of Electronic Publication: 2020 Oct 01. |
| Τύπος έκδοσης: | Journal Article; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Karger Country of Publication: Switzerland NLM ID: 0035665 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0194 (Electronic) Linking ISSN: 00283835 NLM ISO Abbreviation: Neuroendocrinology Subsets: MEDLINE |
| Imprint Name(s): | Publication: Basel : Karger Original Publication: Basel. |
| Ιατρικοί όροι (MeSH): | Intestinal Neoplasms*/diagnosis , Intestinal Neoplasms*/mortality , Intestinal Neoplasms*/pathology , Neuroendocrine Tumors*/diagnosis , Neuroendocrine Tumors*/mortality , Neuroendocrine Tumors*/pathology , Pancreatic Neoplasms*/diagnosis , Pancreatic Neoplasms*/mortality , Pancreatic Neoplasms*/pathology , Stomach Neoplasms*/diagnosis , Stomach Neoplasms*/mortality , Stomach Neoplasms*/pathology , Registries*, Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Consensus ; Neoplasm Grading ; Progression-Free Survival ; Practice Guidelines as Topic |
| Περίληψη: | High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are classified according to morphology as well-differentiated neuroendocrine tumours (NETs) G3 or poorly differentiated neuroendocrine carcinomas (NECs). Little data exist concerning which morphological criteria this subdivision should be based on. Uncertainty exists if the NEC group should be further subdivided according to proliferation rate. Clinical data on NET G3 and NEC with a lower Ki-67 range are limited. A total of 213 patients with high-grade GEP-NEN (Ki-67 >20%) were included from the Nordic NEC Registries. Four experienced NET pathologists re-evaluated the cases to develop the best morphological criteria to separate NET G3 from NEC, assuming longer survival in NET G3. Organoid growth pattern, capillary network in direct contact to tumour cells, and absence of desmoplastic stroma were found to best separate NET G3 from NEC. Of 196 patients with metastatic disease, NET G3 was found in 12.3%, NEC with a Ki-67 <55% (NEC < 55) in 29.6%, and NEC with a Ki-67 ≥55% (NEC ≥ 55) in 56.6%. Only in 1.5%, the morphology was ambiguous. Of 164 patients receiving first-line chemotherapy, 88% received platinum/etoposide treatment. Response rate was higher for NEC ≥ 55 (44%) than that of NEC < 55 (25%) and NET G3 (24%) (p = 0.025 and p = 0.026). Median progression-free survival was 5 months for all groups. Median overall survival was 33 months for NET G3 compared to 11 months for both NEC < 55 and NEC ≥ 55 (p = 0.004 and 0.003). Specific morphological criteria can separate NET G3 from NECs and show prognostic significance. High-grade GEP-NEN patients stratified by morphology and proliferation rate demonstrate significant differences in response to chemotherapy and survival. (© 2020 S. Karger AG, Basel.) |
| Contributed Indexing: | Keywords: Gastroenteropancreatic neuroendocrine neoplasms; Ki-67; Morphology; Neuroendocrine carcinomas; Neuroendocrine tumour grade 3 |
| SCR Disease Name: | Gastro-enteropancreatic neuroendocrine tumor |
| Entry Date(s): | Date Created: 20201001 Date Completed: 20220125 Latest Revision: 20260417 |
| Update Code: | 20260418 |
| DOI: | 10.1159/000511905 |
| PMID: | 33002892 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1423-0194 |
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| DOI: | 10.1159/000511905 |