Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67

CG Genç, M Falconi, S Partelli, F Muffatti, S van Eeden, C Doglioni, HJ Klümpen, CHJ van Eijck, EJM Nieveen van Dijkum

Research output: Contribution to journalArticle

Abstract

Background: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. Methods: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed. Patients who had G1 or G2 tumor without distant metastases or hereditary syndromes were included in the study. The patients were re-categorized into Ki67 0–5 and Ki67 6–20%. Cox regression analysis with log-rank testing for recurrence and survival was performed. Results: The study enrolled 241 patients (86%) with Ki67 0–5% and 39 patients (14%) with Ki67 6–20%. Recurrence was seen in 34 patients (14%) with Ki67 0–5% after a median period of 34 months and in 16 patients (41%) with Ki67 6–20% after a median period of 16 months (p <0.001). The 5-year recurrence-free and 10-year disease-specific survival periods were respectively 90 and 91% for Ki67 0–5% and respectively 55 and 26% for Ki67 6–20% (p <0.001). The overall survival period after recurrence was 44.9 months, which was comparable between the two groups (p = 0.283). In addition to a Ki67 rate higher than 5%, tumor larger than 4 cm and lymph node metastases were independently associated with recurrence. Conclusions: Patients at high risk for recurrence after curative resection of G1 or G2 panNET can be identified by a Ki67 rate higher than 5%. These patients should be more closely monitored postoperatively to detect recurrence early and might benefit from adjuvant treatment. A clear postoperative follow-up regimen is proposed. © 2018, The Author(s).
Original languageEnglish
Pages (from-to)2467-2474
Number of pages8
JournalAnnals of Surgical Oncology
Volume25
Issue number8
DOIs
Publication statusPublished - 2018

Fingerprint

Neuroendocrine Tumors
Recurrence
Survival
Neoplasm Metastasis
Neoplasms
Lymph Nodes
Regression Analysis

Cite this

Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67. / Genç, CG; Falconi, M; Partelli, S; Muffatti, F; van Eeden, S; Doglioni, C; Klümpen, HJ; van Eijck, CHJ; Nieveen van Dijkum, EJM.

In: Annals of Surgical Oncology, Vol. 25, No. 8, 2018, p. 2467-2474.

Research output: Contribution to journalArticle

Genç, CG ; Falconi, M ; Partelli, S ; Muffatti, F ; van Eeden, S ; Doglioni, C ; Klümpen, HJ ; van Eijck, CHJ ; Nieveen van Dijkum, EJM. / Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67. In: Annals of Surgical Oncology. 2018 ; Vol. 25, No. 8. pp. 2467-2474.
@article{52e1b5c705c4479d8c7b3f4e992fdb47,
title = "Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67",
abstract = "Background: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. Methods: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed. Patients who had G1 or G2 tumor without distant metastases or hereditary syndromes were included in the study. The patients were re-categorized into Ki67 0–5 and Ki67 6–20{\%}. Cox regression analysis with log-rank testing for recurrence and survival was performed. Results: The study enrolled 241 patients (86{\%}) with Ki67 0–5{\%} and 39 patients (14{\%}) with Ki67 6–20{\%}. Recurrence was seen in 34 patients (14{\%}) with Ki67 0–5{\%} after a median period of 34 months and in 16 patients (41{\%}) with Ki67 6–20{\%} after a median period of 16 months (p <0.001). The 5-year recurrence-free and 10-year disease-specific survival periods were respectively 90 and 91{\%} for Ki67 0–5{\%} and respectively 55 and 26{\%} for Ki67 6–20{\%} (p <0.001). The overall survival period after recurrence was 44.9 months, which was comparable between the two groups (p = 0.283). In addition to a Ki67 rate higher than 5{\%}, tumor larger than 4 cm and lymph node metastases were independently associated with recurrence. Conclusions: Patients at high risk for recurrence after curative resection of G1 or G2 panNET can be identified by a Ki67 rate higher than 5{\%}. These patients should be more closely monitored postoperatively to detect recurrence early and might benefit from adjuvant treatment. A clear postoperative follow-up regimen is proposed. {\circledC} 2018, The Author(s).",
author = "CG Gen{\cc} and M Falconi and S Partelli and F Muffatti and {van Eeden}, S and C Doglioni and HJ Kl{\"u}mpen and {van Eijck}, CHJ and {Nieveen van Dijkum}, EJM",
year = "2018",
doi = "10.1245/s10434-018-6518-2",
language = "English",
volume = "25",
pages = "2467--2474",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "8",

}

TY - JOUR

T1 - Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67

AU - Genç, CG

AU - Falconi, M

AU - Partelli, S

AU - Muffatti, F

AU - van Eeden, S

AU - Doglioni, C

AU - Klümpen, HJ

AU - van Eijck, CHJ

AU - Nieveen van Dijkum, EJM

PY - 2018

Y1 - 2018

N2 - Background: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. Methods: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed. Patients who had G1 or G2 tumor without distant metastases or hereditary syndromes were included in the study. The patients were re-categorized into Ki67 0–5 and Ki67 6–20%. Cox regression analysis with log-rank testing for recurrence and survival was performed. Results: The study enrolled 241 patients (86%) with Ki67 0–5% and 39 patients (14%) with Ki67 6–20%. Recurrence was seen in 34 patients (14%) with Ki67 0–5% after a median period of 34 months and in 16 patients (41%) with Ki67 6–20% after a median period of 16 months (p <0.001). The 5-year recurrence-free and 10-year disease-specific survival periods were respectively 90 and 91% for Ki67 0–5% and respectively 55 and 26% for Ki67 6–20% (p <0.001). The overall survival period after recurrence was 44.9 months, which was comparable between the two groups (p = 0.283). In addition to a Ki67 rate higher than 5%, tumor larger than 4 cm and lymph node metastases were independently associated with recurrence. Conclusions: Patients at high risk for recurrence after curative resection of G1 or G2 panNET can be identified by a Ki67 rate higher than 5%. These patients should be more closely monitored postoperatively to detect recurrence early and might benefit from adjuvant treatment. A clear postoperative follow-up regimen is proposed. © 2018, The Author(s).

AB - Background: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. Methods: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed. Patients who had G1 or G2 tumor without distant metastases or hereditary syndromes were included in the study. The patients were re-categorized into Ki67 0–5 and Ki67 6–20%. Cox regression analysis with log-rank testing for recurrence and survival was performed. Results: The study enrolled 241 patients (86%) with Ki67 0–5% and 39 patients (14%) with Ki67 6–20%. Recurrence was seen in 34 patients (14%) with Ki67 0–5% after a median period of 34 months and in 16 patients (41%) with Ki67 6–20% after a median period of 16 months (p <0.001). The 5-year recurrence-free and 10-year disease-specific survival periods were respectively 90 and 91% for Ki67 0–5% and respectively 55 and 26% for Ki67 6–20% (p <0.001). The overall survival period after recurrence was 44.9 months, which was comparable between the two groups (p = 0.283). In addition to a Ki67 rate higher than 5%, tumor larger than 4 cm and lymph node metastases were independently associated with recurrence. Conclusions: Patients at high risk for recurrence after curative resection of G1 or G2 panNET can be identified by a Ki67 rate higher than 5%. These patients should be more closely monitored postoperatively to detect recurrence early and might benefit from adjuvant treatment. A clear postoperative follow-up regimen is proposed. © 2018, The Author(s).

U2 - 10.1245/s10434-018-6518-2

DO - 10.1245/s10434-018-6518-2

M3 - Article

VL - 25

SP - 2467

EP - 2474

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 8

ER -