TY - JOUR
T1 - Intratumoral Fibrosis and Tumor Growth Pattern as Prognostic Factors in Optimally Resected Pancreatic Neuroendocrine Neoplasms
T2 - An Analysis of 168 Cases
AU - Chatterjee, Deyali
AU - Trikalinos, Nikolaos A.
AU - Williams, Greg A.
AU - Liu, Jingxia
AU - Hawkins, William G.
AU - Hammill, Chet
N1 - Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objectives Pancreatic neuroendocrine neoplasms (PanNENs) can recur after curative resection. We sought to establish the significance of tumor fibrosis and tumor growth pattern as predictors of recurrence-free survival and overall survival. Methods A retrospective query of an institutional surgical database was performed from 2000 to 2018 to identify optimally resected PanNENs. All eligible slides were reviewed by an experienced gastrointestinal pathologist for established histopathologic prognostic factors, as well as fibrosis and tumor growth pattern. We evaluated the effect of the interested variables through Cox proportional hazards models. Results One hundred sixty-eight cases were considered. The majority of patients (90%) had grade 1 or 2 tumors, 46% showed significant fibrosis, and 22% demonstrated an infiltrative growth pattern. Twenty-one percent of patients had a recurrence. In multivariable analysis, lymphovascular invasion with a hazard ratio (HR) of 5.1 and infiltrative growth pattern (HR, 2.8) were significantly associated with increased risk of recurrence and increased risk of death (HR, 3.6 and 2.7, respectively). There was a significant decrease in recurrence-free survival and overall survival for fibrosis and infiltrative growth pattern. Conclusions In optimally resected PanNENs, the presence of fibrosis and infiltrative growth pattern are significant risk factors for recurrence and/or decreased survival.
AB - Objectives Pancreatic neuroendocrine neoplasms (PanNENs) can recur after curative resection. We sought to establish the significance of tumor fibrosis and tumor growth pattern as predictors of recurrence-free survival and overall survival. Methods A retrospective query of an institutional surgical database was performed from 2000 to 2018 to identify optimally resected PanNENs. All eligible slides were reviewed by an experienced gastrointestinal pathologist for established histopathologic prognostic factors, as well as fibrosis and tumor growth pattern. We evaluated the effect of the interested variables through Cox proportional hazards models. Results One hundred sixty-eight cases were considered. The majority of patients (90%) had grade 1 or 2 tumors, 46% showed significant fibrosis, and 22% demonstrated an infiltrative growth pattern. Twenty-one percent of patients had a recurrence. In multivariable analysis, lymphovascular invasion with a hazard ratio (HR) of 5.1 and infiltrative growth pattern (HR, 2.8) were significantly associated with increased risk of recurrence and increased risk of death (HR, 3.6 and 2.7, respectively). There was a significant decrease in recurrence-free survival and overall survival for fibrosis and infiltrative growth pattern. Conclusions In optimally resected PanNENs, the presence of fibrosis and infiltrative growth pattern are significant risk factors for recurrence and/or decreased survival.
KW - fibrosis
KW - neuroendocrine tumors
KW - recurrence
KW - tumor growth pattern
UR - http://www.scopus.com/inward/record.url?scp=85079353115&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001478
DO - 10.1097/MPA.0000000000001478
M3 - Article
C2 - 32011527
AN - SCOPUS:85079353115
SN - 0885-3177
VL - 49
SP - 255
EP - 260
JO - Pancreas
JF - Pancreas
IS - 2
ER -