Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms: Data from a Large International Cohort Study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms : Data from a Large International Cohort Study. / Rindi, Guido; Klersy, Catherine; Albarello, Luca; Baudin, Eric; Bianchi, Antonio; Buchler, Markus W; Caplin, Martyn; Couvelard, Anne; Cros, Jérôme; de Herder, Wouter W; Delle Fave, Gianfranco; Doglioni, Claudio; Federspiel, Birgitte; Fischer, Lars; Fusai, Giuseppe; Gavazzi, Francesca; Hansen, Carsten P; Inzani, Frediano; Jann, Henning; Komminoth, Paul; Knigge, Ulrich P; Landoni, Luca; La Rosa, Stefano; Lawlor, Rita T; Luong, Tu V; Marinoni, Ilaria; Panzuto, F; Pape, Ulrich-Frank; Partelli, Stefano; Perren, Aurel; Rinzivillo, Maria; Rubini, Corrado; Ruszniewski, Philippe; Scarpa, Aldo; Schmitt, Anja; Schinzari, Giovanni; Scoazec, Jean-Yves; Sessa, Fausto; Solcia, Enrico; Spaggiari, Paola; Toumpanakis, Christos; Vanoli, Alessandro; Wiedenmann, Bertram; Zamboni, Giuseppe; Zandee, Wouter T; Zerbi, Alessandro; Falconi, Massimo.
In: Neuroendocrinology, Vol. 107, No. 4, 2018, p. 375-386.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms
T2 - Data from a Large International Cohort Study
AU - Rindi, Guido
AU - Klersy, Catherine
AU - Albarello, Luca
AU - Baudin, Eric
AU - Bianchi, Antonio
AU - Buchler, Markus W
AU - Caplin, Martyn
AU - Couvelard, Anne
AU - Cros, Jérôme
AU - de Herder, Wouter W
AU - Delle Fave, Gianfranco
AU - Doglioni, Claudio
AU - Federspiel, Birgitte
AU - Fischer, Lars
AU - Fusai, Giuseppe
AU - Gavazzi, Francesca
AU - Hansen, Carsten P
AU - Inzani, Frediano
AU - Jann, Henning
AU - Komminoth, Paul
AU - Knigge, Ulrich P
AU - Landoni, Luca
AU - La Rosa, Stefano
AU - Lawlor, Rita T
AU - Luong, Tu V
AU - Marinoni, Ilaria
AU - Panzuto, F
AU - Pape, Ulrich-Frank
AU - Partelli, Stefano
AU - Perren, Aurel
AU - Rinzivillo, Maria
AU - Rubini, Corrado
AU - Ruszniewski, Philippe
AU - Scarpa, Aldo
AU - Schmitt, Anja
AU - Schinzari, Giovanni
AU - Scoazec, Jean-Yves
AU - Sessa, Fausto
AU - Solcia, Enrico
AU - Spaggiari, Paola
AU - Toumpanakis, Christos
AU - Vanoli, Alessandro
AU - Wiedenmann, Bertram
AU - Zamboni, Giuseppe
AU - Zandee, Wouter T
AU - Zerbi, Alessandro
AU - Falconi, Massimo
N1 - © 2018 S. Karger AG, Basel.
PY - 2018
Y1 - 2018
N2 - BACKGROUND: The World Health Organization (WHO) and the American Joint Cancer Committee (AJCC) modified the grading of pancreatic neuroendocrine neoplasms from a three-tier (WHO-AJCC 2010) to a four-tier system by introducing the novel category of NET G3 (WHO-AJCC 2017).OBJECTIVES: This study aims at validating the WHO-AJCC 2017 and identifying the most effective grading system.METHOD: A total of 2,102 patients were enrolled; entry criteria were: (i) patient underwent surgery; (ii) at least 2 years of follow-up; (iii) observation time up to 2015. Data from 34 variables were collected; grading was assessed and compared for efficacy by statistical means including Kaplan-Meier method, Cox regression analysis, Harrell's C statistics, and Royston's explained variation in univariable and multivariable analyses.RESULTS: In descriptive analysis, the two grading systems demonstrated statistically significant differences for the major category sex but not for age groups. In Cox regression analysis, both grading systems showed statistically significant differences between grades for OS and EFS; however, no statistically significant difference was observed between the two G3 classes of WHO-AJCC 2017. In multivariable analysis for the two models fitted to compare efficacy, the two grading systems performed equally well with substantially similar optimal discrimination and well-explained variation for both OS and EFS. The WHO-AJCC 2017 grading system retained statistically significant difference between the two G3 classes for OS but not for EFS.CONCLUSIONS: The WHO-AJCC 2017 grading system is at least equally performing as the WHO-AJCC 2010 but allows the successful identification of the most aggressive PanNET subgroup. Grading is confirmed as probably the most powerful tool for predicting patient survival.
AB - BACKGROUND: The World Health Organization (WHO) and the American Joint Cancer Committee (AJCC) modified the grading of pancreatic neuroendocrine neoplasms from a three-tier (WHO-AJCC 2010) to a four-tier system by introducing the novel category of NET G3 (WHO-AJCC 2017).OBJECTIVES: This study aims at validating the WHO-AJCC 2017 and identifying the most effective grading system.METHOD: A total of 2,102 patients were enrolled; entry criteria were: (i) patient underwent surgery; (ii) at least 2 years of follow-up; (iii) observation time up to 2015. Data from 34 variables were collected; grading was assessed and compared for efficacy by statistical means including Kaplan-Meier method, Cox regression analysis, Harrell's C statistics, and Royston's explained variation in univariable and multivariable analyses.RESULTS: In descriptive analysis, the two grading systems demonstrated statistically significant differences for the major category sex but not for age groups. In Cox regression analysis, both grading systems showed statistically significant differences between grades for OS and EFS; however, no statistically significant difference was observed between the two G3 classes of WHO-AJCC 2017. In multivariable analysis for the two models fitted to compare efficacy, the two grading systems performed equally well with substantially similar optimal discrimination and well-explained variation for both OS and EFS. The WHO-AJCC 2017 grading system retained statistically significant difference between the two G3 classes for OS but not for EFS.CONCLUSIONS: The WHO-AJCC 2017 grading system is at least equally performing as the WHO-AJCC 2010 but allows the successful identification of the most aggressive PanNET subgroup. Grading is confirmed as probably the most powerful tool for predicting patient survival.
U2 - 10.1159/000494355
DO - 10.1159/000494355
M3 - Journal article
C2 - 30300897
VL - 107
SP - 375
EP - 386
JO - Neuroendocrinology
JF - Neuroendocrinology
SN - 0028-3835
IS - 4
ER -
ID: 216505598