Ann Hepatobiliary Pancreat Surg.  2018 Feb;22(1):66-74. 10.14701/ahbps.2018.22.1.66.

Prognostic factors of non-functioning pancreatic neuroendocrine tumor revisited: The value of WHO 2010 classification

• Bu J
• Youn S
• Kwon W
• Jang KT
• Han S
• Han S
• You Y
• Heo JS
• Choi SH
• Choi DW

• KMID: 2409082
• DOI: http://doi.org/10.14701/ahbps.2018.22.1.66

Abstract

BACKGROUNDS/AIMS
Various factors have been reported as prognostic factors of non-functional pancreatic neuroendocrine tumors (NF-pNETs). There remains some controversy as to the factors which might actually serve to successfully prognosticate future manifestation and diagnosis of NF-pNETs. As well, consensus regarding management strategy has never been achieved. The aim of this study is to further investigate potential prognostic factors using a large single-center cohort to help determine the management strategy of NF-pNETs.
METHODS
During the time period 1995 through 2013, 166 patients with NF-pNETs who underwent surgery in Samsung Medical Center were entered in a prospective database, and those factors thought to represent predictors of prognosis were tested in uni- and multivariate models.
RESULTS
The median follow-up time was 46.5 months; there was a maximum follow-up period of 217 months. The five-year overall survival and disease-free survival rates were 88.5% and 77.0%, respectively. The 2010 WHO classification was found to be the only prognostic factor which affects overall survival and disease-free survival in multivariate analysis. Also, pathologic tumor size and preoperative image tumor size correlated strongly with the WHO grades (p < 0.001, and p < 0.001).
CONCLUSIONS
Our study demonstrates that 2010 WHO classification represents a valuable prognostic factor of NF-pNETs and tumor size on preoperative image correlated with WHO grade. In view of the foregoing, the preoperative image size is thought to represent a reasonable reference with regard to determination and development of treatment strategy of NF-pNETs.

Keyword

NF-pNETs; 2010 WHO classification; Prognostic factors; Image tumor size

MeSH Terms

Classification*
Cohort Studies
Consensus
Diagnosis
Disease-Free Survival
Follow-Up Studies
Humans
Multivariate Analysis
Neuroendocrine Tumors*
Prognosis
Prospective Studies

Figure

• 

  Fig. 1 Kapalan-meier survival curves according to the Grade (WHO 2010 classification) are illustrated. (A) Overall survival after curative resection of NF-pNETs grouped according to the WHO Grade showed significant difference (p<0.001). (B) Disease free survival after curative resection of NF-pNETs also demonstrated significantly differences according the WHO Grade (p<0.001).

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