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- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 1,639 - 1,652 (14page)
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Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system. Materials and Methods We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included. Results Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808, 13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS. Conclusion This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.
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참고문헌 (29)
참고문헌 신청
Amin MB / 2017 / AJCC cancer staging manual / Springer
Yao JC / 2007 / Population-based study of islet cell carcinoma / Ann Surg Oncol 14:3492~3500
Panzuto F / 2011 / Metastatic and locally advanced pancreatic endocrine carcinomas : analysis of factors associated with disease progression / J Clin Oncol 29:2372~2377
Modlin IM / 2008 / Priorities for improving the management of gastroenteropancreatic neuroendocrine tumors / J Natl Cancer Inst 100:1282~1289
Yao JC / 2008 / One hundred years after"carcinoid" : epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States / J Clin Oncol 26:3063~3072
Yao JC / 2007 / Population-based study of islet cell carcinoma / Ann Surg Oncol 14:3492~3500
Panzuto F / 2011 / Metastatic and locally advanced pancreatic endocrine carcinomas : analysis of factors associated with disease progression / J Clin Oncol 29:2372~2377
Modlin IM / 2008 / Priorities for improving the management of gastroenteropancreatic neuroendocrine tumors / J Natl Cancer Inst 100:1282~1289
Yao JC / 2008 / One hundred years after"carcinoid" : epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States / J Clin Oncol 26:3063~3072
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