The first two authors contributed equally to this article.
Gastroenteric neuroendocrine neoplasms classification: Comparison of prognostic models
Version of Record online: 28 JUN 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 1, pages 36–44, 1 January 2013
How to Cite
Dolcetta-Capuzzo, A., Villa, V., Albarello, L., Franchi, G. M., Gemma, M., Scavini, M., Di Palo, S., Orsenigo, E., Bosi, E., Doglioni, C. and Manzoni, M. F. (2013), Gastroenteric neuroendocrine neoplasms classification: Comparison of prognostic models. Cancer, 119: 36–44. doi: 10.1002/cncr.27716
- Issue online: 17 DEC 2012
- Version of Record online: 28 JUN 2012
- Manuscript Accepted: 25 MAY 2012
- Manuscript Revised: 17 MAY 2012
- Manuscript Received: 11 APR 2012
- neuroendocrine tumors;
- neuroendocrine neoplasm;
- gastroenteric tract;
- World Health Organization
Gastroenteric neuroendocrine neoplasms (GE-NENs) display highly variable clinical behavior. In an attempt to assess a better prognostic description, in 2010, the World Health Organization (WHO) updated its previous classification, and the European Neuroendocrine Tumors Society (ENETS) proposed a new grading and TNM-based staging system. In the current study, the authors evaluated the prognostic significance of these models and compared their efficacy in describing patients' long-term survival to assess the best prognostic model currently available for clinicians.
The study cohort was composed of 145 patients with extrapancreatic GE-NEN who were observed from 1986 to 2008 at a single center and were classified according to the WHO and ENETS classifications. Survival evaluations were performed using Kaplan-Meyer analyses on 131 patients. Only deaths from neoplasia were considered. A P value < .05 was considered significant. Prognostic efficacy was assessed by determining the Harrell concordance index (c-index).
Both the 2010 WHO and the ENETS classification were able to efficiently divide patients into classes with different prognoses. According to the model comparison, the ENETS TNM-based staging system appeared to be the strongest. All combined models were effective prognostic predictors, but the model that included the 2010 WHO classification plus ENETS staging had a higher c-index.
Both the 2010 WHO classification and the ENETS staging system are valid instruments for GE-NENs prognostic assessment, with TNM-based stage appearing to be the best available choice for clinicians, both alone and in association with other classifications. Cancer 2013. © 2012 American Cancer Society.