Jae Hee Cho1, Ji Kon Ryu, Si Young Song, Jin-Hyeok Hwang, Dong Ki Lee, Sang Myung Woo, Young-Eun Joo, Seok Jeong, Seung-Ok Lee, Byung Kyu Park, Young Koog Cheon, Jimin Han, Tae Nyeun Kim, Jun Kyu Lee, Sung-Hoon Moon, Hyunjin Kim, Eun Taek Park, Jae Chul Hwang, Tae Hyeon Kim, Tae Joo Jeon, Chang-Min Cho, Ho Soon Choi, Woo Jin Lee. 1. From the *Department of Internal Medicine, Gachon University Gil Medical Center, Incheon; †Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul; ‡Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul; §Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang; ∥Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; ¶Center for Liver Cancer, National Cancer Center, Goyang; #Department of Internal Medicine, Chonnam National University Medical School, Gwangju; **Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon; ††Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Jeonju; ‡‡Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang; §§Department of Internal Medicine, Konkuk University School of Medicine, Seoul; ∥∥Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu; ¶¶Department of Internal Medicine, Yeungnam University College of Medicine, Daegu; ##Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang; ***Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang; †††Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju; ‡‡‡Department of Internal Medicine, Kosin University School of Medicine, Busan; §§§Department of Internal Medicine, Ajou University School of Medicine, Suwon; ∥∥∥Department of Internal Medicine, Wonkwang University College of Medicine, Iksan; ¶¶¶Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul; ###Department of Internal Medicine, Kyungpook National University College of Medicin
Abstract
OBJECTIVES: Pancreatic neuroendocrine tumors (pNETs) are diverse diseases with different prognosis. The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) introduced 2 different tumor node metastasis (TNM) stages, and the World Health Organization (WHO) proposed WHO 2010 grading system for pNETs. Therefore, we aimed to validate the prognostic relevance of these 3 systems for pNETs in South Korea. METHODS: The Korean Society of Gastrointestinal Cancer created a retrospective registry of pNETs in 153 patients from 15 hospitals between 2002 and 2012. RESULTS: On the basis of the WHO 2010 grade, 2-year progression-free-survival (PFS) rates for G1, G2, and G3 were 92%, 62%, and 25% (P < 0.01). According to ENETS and AJCC staging, 2-year PFS rates for stages I through IV were 94%, 87%, 49%, 20%, and 92%, 61%, 60%, 20%, respectively (P < 0.01). A Cox multivariate regression analysis revealed that the only statistically significant prognostic factor was the TNM classification of either the AJCC or the ENETS stage (P < 0.01). In addition, the κ value between the AJCC and the ENETS stages was 0.46 indicating a "moderate" agreement (P < 0.01). CONCLUSIONS: The AJCC and ENETS TNM classifications for pNETs are prognostic for PFS and can be adopted in clinical practice in South Korea.
OBJECTIVES:Pancreatic neuroendocrine tumors (pNETs) are diverse diseases with different prognosis. The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) introduced 2 different tumor node metastasis (TNM) stages, and the World Health Organization (WHO) proposed WHO 2010 grading system for pNETs. Therefore, we aimed to validate the prognostic relevance of these 3 systems for pNETs in South Korea. METHODS: The Korean Society of Gastrointestinal Cancer created a retrospective registry of pNETs in 153 patients from 15 hospitals between 2002 and 2012. RESULTS: On the basis of the WHO 2010 grade, 2-year progression-free-survival (PFS) rates for G1, G2, and G3 were 92%, 62%, and 25% (P < 0.01). According to ENETS and AJCC staging, 2-year PFS rates for stages I through IV were 94%, 87%, 49%, 20%, and 92%, 61%, 60%, 20%, respectively (P < 0.01). A Cox multivariate regression analysis revealed that the only statistically significant prognostic factor was the TNM classification of either the AJCC or the ENETS stage (P < 0.01). In addition, the κ value between the AJCC and the ENETS stages was 0.46 indicating a "moderate" agreement (P < 0.01). CONCLUSIONS: The AJCC and ENETS TNM classifications for pNETs are prognostic for PFS and can be adopted in clinical practice in South Korea.