Authors: Federica Grillo Manuela Albertelli Francesca Annunziata Mara Boschetti Andrea Caff Simona Pigozzi Diego Ferone Luca Mastracci
Publish Date: 2015/09/11
Volume: 53, Issue: 1, Pages: 58-62
Abstract
Gastroenteropancreatic GEP neuroendocrine tumors NETs are rare neoplasms with heterogeneous clinical behavior and potential longterm survival In 2006/2007 the European Neuroendocrine Tumors Society introduced an important parameter grade based on mitoses and Ki67 proliferation rate which became part of the latest 2010WHO classification Since this is an important tool in the choice of therapeutic algorithm of patients with NETs our aim was to audit whether retrospective reclassification is possible and feasible and correlate pathological findings with survival From the histopathology archive 338 GEPNETs 1994–2014 were identified of which 250 were diagnosed pre2010 and 80 of these have needed up till now classification morphology and grade—mitotic count/Ki67 Morphology was well differentiated WD in 74 cases while only 6 cases were poorly differentiated PD Grade was reclassified G1—45 cases 56 G2—28 cases 35 G3—7 cases 9 Overall survival OS in WD NETs was strikingly better compared to PD neoplasms Differences in OS between grade were statistically significant p 00001 and in particular grade identified a subgroup of patients with WD lesions but with less favorable clinical behavior OS at 5 years G1—89 G2—48 G3—0 G1 vs G2 p = 003 Feasibility analysis quantified time for reclassification to be between 45 and 64 min/case Our series confirms the importance of grade in prognostic stratification and underlines that reclassification is feasible and may prove worthwhile in patient management especially in view of the potential long survival of patients with NETs and risk of use of inappropriate therapies
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