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Table 2 Clinical features of p-NENs in the present study according to the WHO 2017 and 2010 grading classification

From: World Health Organization grading classification for pancreatic neuroendocrine neoplasms: a comprehensive analysis from a large Chinese institution

Factor

WHO 2017/2010 criteriaA

WHO 2017 criteriaA

WHO 2010 criteriaA

 

NET G1

(N = 150)

NET G2

(N = 158)

NET G3

(N = 64)

NEC G3

(N = 108)

“NEC G3”

(N = 172)

All

(N = 480)

Gender

 Female

88 (58.7%)

97 (61.4%)

38 (59.4%)

62 (57.5%)

100 (58.1%)

285 (59.4%)

Age, yrs.

 Mean ± SD

45.7 ± 15.

49.1 ± 8.5

50.2 ± 7.8

54.1 ± 9.2

52.7 ± 10.

49.5 ± 8.6

 Median

2

48

52

57

253

50

 Range

45 7–68

12–82

7–71

14–80

7–80

7–82

 Tumor size, cm.

2.9 ± 2.1

5.5 ± 2.8

5.6 ± 3.5

5.9 ± 4.1

5.1 ± 3.9

5.6 ± 4.8

 Mean ± SD

2.0

4.0

4.5

5.6

5.1

4.0

 Median Range

0.3–7.2

1.2–14.5

1.8–7.6

1.6–13.1

1.6–13.1

0.3–14.5

Functional status

 Non-functional

62 (41.3%)

88 (55.7%)

44 (68.7%)

72 (66.7%)

116 (67.4%)

266 (55.4%)

 FunctionalB

88 (58.7%)

70 (44.3%)

20 (31.3%)

36 (33.3%)

56 (32.6%)

214 (44.6%)

 Incidental diagnosis

35 (23.3%)

46 (29.1%)

14 (21.9%)

25 (23.1%)

39 (22.7%)

120 (25.0%)

 Diagnosis after 2010

98 (65.3%)

108 (68.4%)

54 (84.4%)

89 (82.4%)

143 (83.1%)

349 (72.7%)

 Tumor location

 Body/tail

85 (56.7%)

100 (63.3%)

43 (67.2%)

68 (62.9%)

111 (64.5%)

296 (61.7%)

Surgical margin

 ″R0C

126 (84.0%)

124 (78.5%)

33 (82.5%)

46 (70.7%)

89 (84.8%)

339 (70.6%)

 Postoperative medical therapyD

31 (20.7%)

41 (25.9%)

29 (45.3%)

61 (56.5%)

90 (52.3%)

162 (33.8%)

 Vascular infiltration

16 (10.7%)

32 (20.3%)

16 (25.0%)

35 (32.4%)

51 (29.7%)

99 (45.3%)

 Lymph involvement

35 (23.3%)

52 (32.9%)

22 (34.4%)

50 (46.3%)

72 (41.9%)

159 (33.1%)

 Distant metastasisE

20 (13.3%)

30 (19.0%)

12 (18.7%)

32 (29.6%)

44 (25.6%)

94 (19.6%)

 Hepatic

12 (8.0%)

15 (9.5%)

6 (9.4%)

20 (18.5%)

26 (15.1%)

51 (10.6%)

 Bone

5 (3.3%)

8 (5.1%)

3 (4.7%)

10 (9.3%)

13 (7.5%)

26 (5.4%)

 Lymph nodal

10 (6.6%)

14 (8.9%)

4 (6.3%)

16 (14.8%)

20 (11.6%)

44 (9.2%)

 Out of contact

30 (20.0%)

38 (24.1%)

9 (14.1%)

23 (21.3%)

32 (18.6%)

100 (20.4%)

 Dead at follow-up

44 (36.7%)

48 (40.0%)

28 (50.9%)

56 (69.1%)

84 (60.0%)

176 (46.3%)

 5-year OS

75.8%

58.4%

35.1%

11.1%

21.2%

53.0%

 MST, mons.

85.3

67.4

51.3

26.8

34.5

63.1

TNM staging system by AJCC 2017 8th staging manualF

Stage I

Stage II

Stage III

Stage IV

WHO 2017 NET G1/G2/G3G (N = 372)

WHO 2017 NEC G3G (N = 108)

Cases(%)

Out of contact

Dead at follow-up

5-year OS

Cases(%)

Out of contact

Dead at follow-up

3-year OS

116 (31.2%)

108 (29.1%)

86 (23.1%)

62 (16.6%)

16 (13.8%)

20 (18.5%)

20 (23.6%)

20 (32.3%)

19 (19.0%)

23 (26.1%)

41 (62.1%)

37 (88.1%)

89.2%

70.5%

51.2%

18.9%

18 (16.7%)

30 (27.8%)

28 (25.9%)

32 (29.6%)

6 (33.7%)

10 (33.3%)

2 (7.1%)

6 (18.8%)

6 (50.0%)

13 (65.0%)

19 (73.1%)

18 (69.2%)

80.8%

33.2%

7.1%

NA

  1. A: The NET G1 and NET G2 were consistently defined in WHO 2017 and 2010 grading criteria for p-NENs, while the “NEC G3” of WHO 2010 criteria was composed of both NET G3 and NEC G3 of WHO 2017 criteria [8, 14]
  2. B: Referring to insulinoma, gastrinoma, vasoactive intestinal polypeptidoma, adrenocorticotropic hormone adenoma, glucagonoma, pheochromocytoma, etc.
  3. C: Referring to radical resections with both grossly and microscopically negative surgical margins
  4. D: Referring to conventional chemotherapy and novel molecular targeted therapies
  5. E: Distant metastases (hepatic, bone, lymph nodal) for patients with p-NENs was present at diagnosis
  6. F: In the AJCC 2017 staging manual, one TNM system was originally proposed for G1/G2 p-NETs, the other for “G3 p-NECs” of WHO 2010 criteria
  7. G: The G3 p-NETs of WHO 2017 grading classification were also staged by the system for G1/G2 p-NETs, while the G3 p-NECs of WHO 2017 criteria were staged by the system for pancreatic exocrine adenocarcinomas, as we have demonstrated in the previous report [19]
  8. Abbreviations: p-NENs Pancreatic neuroendocrine neoplasms; WHO World Health Organization; NET Neuroendocrine tumors; NEC Neuroendocrine carcinoma; G Grading; TNM Tumor-node-metastasis; AJCC American Joint Committee On Cancer; NA Not applicable; OS Overall survival; MST Median survival time