Surgery for Pancreatic Neuroendocrine Tumor G3 and Carcinoma G3 Should be Considered Separately.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
May 2019
Historique:
received: 27 08 2018
pubmed: 14 3 2019
medline: 6 8 2019
entrez: 14 3 2019
Statut: ppublish

Résumé

The role of surgery in pancreatic neuroendocrine neoplasm grade 3 (pNEN-G3) treatment remains unclear. We aimed to clarify the role of surgery for pNEN-G3, which has recently been reclassified as pancreatic neuroendocrine tumor-G3 (pNET-G3) and pancreatic neuroendocrine carcinoma-G3 (pNEC-G3), with and without metastases, respectively. We analyzed a subgroup of patients from the Japanese pancreatic NEC study, a Japanese multicenter case-series study of pNEN-G3. Pathologists subclassified 67 patients as having pNET-G3 or pNEC-G3 based on morphological features. We compared the overall survival (OS) rates among patients who were grouped according to whether they had undergone tumor-targeted surgery for tumors without (SwoM) or with (SwM) metastases, or non-surgical procedures (NS). Data from 21 patients with pNET-G3 (SwoM, n = 6; SwM, n = 5; NS, n = 10) and 46 patients with pNEC-G3 (SwoM, n = 8; SwM, n = 5; NS, n = 33) were analyzed. OS of patients with pNET-G3 was significantly longer after SwoM and SwM than with NS (p = 0.018 and p = 0.022). In contrast, OS did not significantly differ between either SwoM or SwM and NS (p = 0.093 and p = 0.489) among patients with pNEC-G3. The role of surgery should be considered separately for pNET-G3 and pNEC-G3. Although SwoM and SwM can be considered for pNET-G3, caution is advised before considering SwM and SwoM for pNEC-G3.

Sections du résumé

BACKGROUND BACKGROUND
The role of surgery in pancreatic neuroendocrine neoplasm grade 3 (pNEN-G3) treatment remains unclear. We aimed to clarify the role of surgery for pNEN-G3, which has recently been reclassified as pancreatic neuroendocrine tumor-G3 (pNET-G3) and pancreatic neuroendocrine carcinoma-G3 (pNEC-G3), with and without metastases, respectively.
METHODS METHODS
We analyzed a subgroup of patients from the Japanese pancreatic NEC study, a Japanese multicenter case-series study of pNEN-G3. Pathologists subclassified 67 patients as having pNET-G3 or pNEC-G3 based on morphological features. We compared the overall survival (OS) rates among patients who were grouped according to whether they had undergone tumor-targeted surgery for tumors without (SwoM) or with (SwM) metastases, or non-surgical procedures (NS).
RESULTS RESULTS
Data from 21 patients with pNET-G3 (SwoM, n = 6; SwM, n = 5; NS, n = 10) and 46 patients with pNEC-G3 (SwoM, n = 8; SwM, n = 5; NS, n = 33) were analyzed. OS of patients with pNET-G3 was significantly longer after SwoM and SwM than with NS (p = 0.018 and p = 0.022). In contrast, OS did not significantly differ between either SwoM or SwM and NS (p = 0.093 and p = 0.489) among patients with pNEC-G3.
CONCLUSION CONCLUSIONS
The role of surgery should be considered separately for pNET-G3 and pNEC-G3. Although SwoM and SwM can be considered for pNET-G3, caution is advised before considering SwM and SwoM for pNEC-G3.

Identifiants

pubmed: 30863939
doi: 10.1245/s10434-019-07252-8
pii: 10.1245/s10434-019-07252-8
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1385-1393

Subventions

Organisme : Japan Agency for Medical Research and Development
ID : JP15ck0106138h0002
Organisme : Japan Society for the Promotion of Science
ID : JP26461041

Auteurs

Tsukasa Yoshida (T)

Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
Department of Gastroenterology, Kizawa Memorial Hospital, Minokamo, Japan.

Susumu Hijioka (S)

Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan. shijioka@ncc.go.jp.
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan. shijioka@ncc.go.jp.

Waki Hosoda (W)

Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan.
Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Makoto Ueno (M)

Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan.

Masayuki Furukawa (M)

Department of Hepato-Biliary-Pancreatology, National Kyushu Cancer Center, Fukuoka, Japan.

Noritoshi Kobayashi (N)

Department of Oncology, Yokohama City University Hospital, Yokohama, Japan.

Masafumi Ikeda (M)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Tetsuhide Ito (T)

Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Yuzo Kodama (Y)

Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Chigusa Morizane (C)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Kenji Notohara (K)

Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan.

Hiroki Taguchi (H)

Department of Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Masayuki Kitano (M)

Department of Gastroenterology and Hepatology, Kinki University, Faculty of Medicine, Sayama, Japan.

Kei Yane (K)

Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan.

Yoshiaki Tsuchiya (Y)

Department of Digestive Surgery, Niigata Cancer Center Hospital, Niigata, Japan.

Izumi Komoto (I)

Department of Surgery, Kansai Electric Power Hospital, Osaka, Japan.

Hiroki Tanaka (H)

Department of Gastroenterology, Suzuka General Hospital, Suzuka, Japan.

Akihito Tsuji (A)

Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan.

Syunpei Hashigo (S)

Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Tetsuya Mine (T)

Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan.

Atsushi Kanno (A)

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Go Murohisa (G)

Department of Gastroenterology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.

Katsuyuki Miyabe (K)

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Tadayuki Takagi (T)

Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.

Nobutaka Matayoshi (N)

Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Masafumi Sakaguchi (M)

Department of Gastroenterology, Saiseikai Kumamoto Hospital, Kumamoto, Japan.

Hiroshi Ishii (H)

Department of Gastroenterology, Shikoku Cancer Center, Matsuyama, Japan.
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.

Yasushi Kojima (Y)

Department of Gastroenterology, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.

Keitaro Matsuo (K)

Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.

Hideyuki Yoshitomi (H)

Department of General Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.

Shoji Nakamori (S)

Department of Hepato-biliary-Pancreatic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.

Hiroaki Yanagimoto (H)

Department of Surgery, Kansai Medical University Hospital, Maikata, Japan.

Yasushi Yatabe (Y)

Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan.

Junji Furuse (J)

Department of Medical Oncology, Kyorin University Faculty of Medicine, Mitaka, Japan.

Nobumasa Mizuno (N)

Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.

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