TY - JOUR
T1 - The Clinicopathologic Heterogeneity of Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms
T2 - Morphological Differentiation and Proliferation Identify Different Prognostic Categories
AU - Milione, Massimo
AU - Maisonneuve, Patrick
AU - Spada, Francesca
AU - Pellegrinelli, Alessio
AU - Spaggiari, Paola
AU - Albarello, Luca
AU - Pisa, Eleonora
AU - Barberis, Massimo
AU - Vanoli, Alessandro
AU - Buzzoni, Roberto
AU - Pusceddu, Sara
AU - Concas, Laura
AU - Sessa, F.
AU - Solcia, Enrico
AU - Capella, Carlo
AU - Fazio, Nicola
AU - La Rosa, Stefano
PY - 2016/3/5
Y1 - 2016/3/5
N2 - Background/Aims: Gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) are defined as neuroendocrine neoplasms (NENs) with >20% Ki-67 index according to the 2010 WHO classification. Some reports suggest that this category is heterogeneous. We retrospectively studied a series of 136 patients affected by grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) with the aim to clarify the prognostic role of tumor morphological differentiation, proliferation, defect in mismatch repair proteins (MMRd), CD117 expression, and site of origin. The primary endpoint was the correlation between these parameters and the overall survival (OS). Methods: Univariable and multivariable Cox proportional hazards regression analyses were used to assess the prognostic significance of various clinical and histopathologic features. Results: With a median follow-up of 81 months, the median OS was 12.9 months. At multivariate analysis, morphological differentiation, Ki67 index, MMRd, stage, and CD117 expression were independent prognostic markers in NECs. Three different prognostic categories of NECs were identified according to the degree of morphologic differentiation (well versus poorly-differentiated) and Ki67 index (
AB - Background/Aims: Gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) are defined as neuroendocrine neoplasms (NENs) with >20% Ki-67 index according to the 2010 WHO classification. Some reports suggest that this category is heterogeneous. We retrospectively studied a series of 136 patients affected by grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) with the aim to clarify the prognostic role of tumor morphological differentiation, proliferation, defect in mismatch repair proteins (MMRd), CD117 expression, and site of origin. The primary endpoint was the correlation between these parameters and the overall survival (OS). Methods: Univariable and multivariable Cox proportional hazards regression analyses were used to assess the prognostic significance of various clinical and histopathologic features. Results: With a median follow-up of 81 months, the median OS was 12.9 months. At multivariate analysis, morphological differentiation, Ki67 index, MMRd, stage, and CD117 expression were independent prognostic markers in NECs. Three different prognostic categories of NECs were identified according to the degree of morphologic differentiation (well versus poorly-differentiated) and Ki67 index (
KW - Classification
KW - Morphology
KW - Neuroendocrine carcinoma
KW - Prognosis
KW - Proliferation
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U2 - 10.1159/000445165
DO - 10.1159/000445165
M3 - Article
JO - Neuroendocrinology
JF - Neuroendocrinology
SN - 0028-3835
ER -