Francesco Panzuto1, Davide Campana2, Sara Massironi3, Antongiulio Faggiano4, Maria Rinzivillo5, Giuseppe Lamberti6, Valentina Sciola3, Edith Lahner7, Lisa Manuzzi6, Annamaria Colao8, Bruno Annibale7. 1. Digestive Disease Unit, Sant'Andrea University Hospital, Rome ENETS Center of Excellence, Italy. Electronic address: fpanzuto@ospedalesantandrea.it. 2. NET Team Bologna ENETS Center of Excellence, Dept. of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy. 3. Gastroenterology and Endoscopy Unit, Ca' Granda Foundation IRCCS, Policlinico Hospital of Milan, Italy. 4. Endocrinology Unit, Dept. of Experimental Medicine, Sapienza University of Rome, Italy. 5. Digestive Disease Unit, Sant'Andrea University Hospital, Rome ENETS Center of Excellence, Italy. 6. Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy. 7. Digestive Disease Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University Rome, Italy. 8. Naples ENETS Center of Excellence, Dept. of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
Abstract
BACKGROUND: Gastric neuroendocrine neoplasias (gNEN) are defined as type I if associated with atrophic body gastritis and type III when tumour is sporadic. This classification, together with grading and size, plays a crucial prognostic role. Nevertheless, the impact of these features on clinical outcome is not clear. AIM: To identify factors predicting poor outcome. PATIENTS AND METHODS: Analysis of type I and type III gNEN. A composite endpoint was defined if tumour-related death or metastases or angioinvasion were observed. RESULTS: 156 gNENs were evaluated: 137 (87.8%) type I and 19 (12.2%) type III. Among type I, 103 were G1 (75.2%) and 34 (24.8%) were G2. In type III group, 8 were G1 (42.1%), 10 were G2 (52.6%), and 1 was G3 (5.3%). Negative endpoint occurred in 18 patients including 10 type III and 8 type I. Male gender (p = 0.032), tumour type (p = 0.003) and size >10 mm (p = 0.024) were predictors for poor outcome, whereas Ki67 was not confirmed on multivariate analysis (p = 0.192). 5-yr survival rates in type I and type III were 100% and 76.2%, respectively (p = 0.0002). CONCLUSIONS: Tumour size, tumour type and gender affect clinical outcome in gNENs. In contrast to NENs rising from other sites, Ki67 plays a less important role.
BACKGROUND:Gastric neuroendocrine neoplasias (gNEN) are defined as type I if associated with atrophic body gastritis and type III when tumour is sporadic. This classification, together with grading and size, plays a crucial prognostic role. Nevertheless, the impact of these features on clinical outcome is not clear. AIM: To identify factors predicting poor outcome. PATIENTS AND METHODS: Analysis of type I and type III gNEN. A composite endpoint was defined if tumour-related death or metastases or angioinvasion were observed. RESULTS: 156 gNENs were evaluated: 137 (87.8%) type I and 19 (12.2%) type III. Among type I, 103 were G1 (75.2%) and 34 (24.8%) were G2. In type III group, 8 were G1 (42.1%), 10 were G2 (52.6%), and 1 was G3 (5.3%). Negative endpoint occurred in 18 patients including 10 type III and 8 type I. Male gender (p = 0.032), tumour type (p = 0.003) and size >10 mm (p = 0.024) were predictors for poor outcome, whereas Ki67 was not confirmed on multivariate analysis (p = 0.192). 5-yr survival rates in type I and type III were 100% and 76.2%, respectively (p = 0.0002). CONCLUSIONS:Tumour size, tumour type and gender affect clinical outcome in gNENs. In contrast to NENs rising from other sites, Ki67 plays a less important role.
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