The American journal of surgical pathology
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Am. J. Surg. Pathol. · Jun 2013
Comparative StudyComparison of WHO Classifications (2004, 2010), the Hochwald grading system, and AJCC and ENETS staging systems in predicting prognosis in locoregional well-differentiated pancreatic neuroendocrine tumors.
It is difficult to predict prognosis in patients with locoregional well-differentiated (WD) pancreatic neuroendocrine tumors (PanNET). We aimed to examine commonly used stratification systems [World Health organization (WHO) 2004 and 2010 classifications, American Joint Committee on Cancer (AJCC) and European Neuroendocrine Tumor Society (ENETS) staging, and the Hochwald grading system] for their power in predicting recurrence-free survival (RFS) in these patients. Seventy-five such patients (mean age 56 y, mean follow-up 79 mo) who underwent resection with sufficient tissue material and follow-up data were studied. ⋯ When these systems were analyzed in conjunction with various additional important pathologic features, combination of the Hochwald grading system and Ki-67 PI achieved the highest CI (0.7946). Therefore, although all these systems predict RFS well in locoregional WD PanNETs, the Hochwald grading system achieves the highest predictive ability. Further predictive power can be achieved by combining the Hochwald grading system and Ki-67 PI.