MODIFIED HISTOPATHOLOGICAL GRADING OPTIMIZES PREDICTION OF SURVIVAL OUTCOMES IN SMALL INTESTINAL NEUROENDOCRINE TUMOURS

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Fältnamn	Indikatorer	Metadata
000		04629naa a2200385 4500
001		oai:DiVA.org:oru-114139
003		SwePub
008		240612s2024 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-1141392 URI
024	7	a https://doi.org/10.1093/bjs/znae104.0022 DOI
040		a (SwePub)oru
041		a engb eng
042		9 SwePub
072	7	a vet2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Daskalakis, Kosmas,d 1979-u Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län4 aut0 (Swepub:oru)kds
245	1 0	a MODIFIED HISTOPATHOLOGICAL GRADING OPTIMIZES PREDICTION OF SURVIVAL OUTCOMES IN SMALL INTESTINAL NEUROENDOCRINE TUMOURS
264	1	b Oxford University Press,c 2024
338		a print2 rdacarrier
520		a Background: We aimed to identify optimal grading Ki-67 cut-offs to delineate differences in prognosis of patients with small intestinal neuroendocrine tumours (SI-NETs) in terms of overall- and event-free survival rates.Methods: We included 551 patients with SI-NETs diagnosed from June 15th, 1993, through March 8th, 2021, identified using the SI-NET databases from five European referral centers.Results: Median age at baseline was 62.3(17-90) years; 252 patients were women (45.7%). All tumours were well-differentiated; 326 were G1 tumours (59.2%), 169 G2(30.7%), only 8 G3(1.5%), while 48 tumourswere of unspecified grade (8.7%). The median Ki67 was 2%(1-70%). 247 patients(44.8%) had distant metastases at baseline (stage IV), 217locoregional disease (41.1%; stage III), whereas 29(7.1%) and 25(4.5%) presented at stages II and I, respectively. Within a mean(SD) follow-up of 51.5(52.9) months, 94 patients(17.1%) died, whereas overall 188 experienced disease recurrence, progression and/or death(34.1%). The median OS was 214.7(95%CI: 152.7-276.6) months and the median EFS was 79.8(95%CI: 68.2-91.5) months, respectively. In multivariable Cox-regression OS analysis, age (HR=1.07, 95%CI: 1.04-1.09; p<0.001), Charlson Comorbidity Index(HR=1.1, 95%CI: 1.03-1.17; p=0.006) and the proposed modified histopathological Ki67 grading system(K67:5-10% group: HR=2.4, 95%CI: 1.3-4.5; p=0.007 and K67≥10% group: HR=5.1, 95%CI: 2.9-9.2; p<0.001) were independent predictors for death. Pertinent EFS analysis, confirmed age(HR=1.04, 95%CI: 1.02-1.05;p<0.001) and the proposed modified histopathological Ki67 grading system(K67≥10% group: HR=4; 95%CI:2.5-6.2;p<0.001) as independent predictors for recurrence, progression and/or death.Conclusions: Ki-67 proliferation index is an independent predictor of EFS and OS. A modified site-specific histopathological grading system applying Ki-67 cut-offs of 5% and 10% seems more optimal to predict differences in SI-NET patient prognosis
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
700	1	a Tsoli, M.u National and Kapodistrian University of Athens, Athens, Greece4 aut
700	1	a Wallin, Göran,d 1952-u Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län4 aut0 (Swepub:oru)gwn
700	1	a Kogut, A.u Department of Endocrinology and Neuroendocrine Neoplasms, Department of Endocrinology and Pathophysiology, Medical University of Silesia, Katowice, Poland4 aut
700	1	a Srirajaskanthan, R.u ENETS Centre of Excellence, Neuroendocrine Tumour Unit, King’s College Hospital, London, United Kingdom4 aut
700	1	a Giovos, G.u The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, London, United Kingdom4 aut
700	1	a Weickert, M. O.u The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, London, United Kingdom4 aut
700	1	a Kos-Kudla, B.u ENETS Centre of Excellence, Neuroendocrine Tumour Unit, King’s College Hospital, London, United Kingdom4 aut
700	1	a Kaltsas, G.u National and Kapodistrian University of Athens, Athens, Greece4 aut
710	2	a Örebro universitetb Institutionen för medicinska vetenskaper4 org
773	0	t British Journal of Surgeryd : Oxford University Pressg 111:Suppl. 4q 111:Suppl. 4x 0007-1323x 1365-2168
856	4	u https://doi.org/10.1093/bjs/znae104.002y Fulltext
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-114139
856	4 8	u https://doi.org/10.1093/bjs/znae104.002

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Av författaren/redakt...: Daskalakis, Kosm ...; Tsoli, M.; Wallin, Göran, 1 ...; Kogut, A.; Srirajaskanthan, ...; Giovos, G.; visa fler...; Weickert, M. O.; Kos-Kudla, B.; Kaltsas, G.; visa färre...

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