Background
This article aims to validate and compare the performance of 6 prognostication systems—the World
Health Organization 2010 grading criteria, the European Neuroendocrine Tumour Society
and the American Joint Committee for Cancer staging systems, the Memorial Sloan Kettering
Cancer Center staging and grading systems, as well as the Bilimoria criteria in a
cohort of patients with pancreatic neuroendocrine neoplasms at a single institution.
Methods
A retrospective review of 176 patients with histologically proven pancreatic neuroendocrine
neoplasm was performed. The prognostic ability of the various prognostication systems
for pancreatic neuroendocrine neoplasm was assessed by analyzing the homogeneity,
discriminatory ability, monotonicity of gradient, and Akaike information criteria.
Results
The 5-year overall survival for the 176 patients was 69% and 5-year recurrence-free
survival in 119 patients who underwent curative resection was 78%. Comparison between
the 6 prognostication systems demonstrated that the World Health Organization 2010
system had the lowest Akaike information criteria score and was hence the best prognostication
system in predicting overall survival and recurrence-free survival rates in our cohort
of patients. The European Neuroendocrine Tumour Society was superior to the American
Joint Committee for Cancer in prognosticating overall survival rates for pancreatic
neuroendocrine neoplasms, as there was a statistically significant difference in overall
survival across the different stages when stratified by the European Neuroendocrine
Tumour Society, while the use of the American Joint Committee for Cancer was limited
to distinguishing between patients in stages I and II versus stages III and IV only.
Conclusion
All 6 prognostication systems were useful in the prognostication of pancreatic neuroendocrine
neoplasm. The World Health Organization 2010 grading system was the best prognostication
system in predicting both overall survival in our entire cohort of patients and recurrence-free
survival in the subset of patients who underwent curative resection.
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Article info
Publication history
Published online: January 19, 2017
Accepted:
December 2,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
