Min Yang, Jie-Yu Wen, Gui-Zhen Qian, Ting Yang, Xu-Bao Liu, Bo-le Tian, Yi Zhang, Yi Ji
{"title":"改良的TNM分期系统用于分化良好的胰腺神经内分泌肿瘤：与AJCC第9版的比较研究。","authors":"Min Yang, Jie-Yu Wen, Gui-Zhen Qian, Ting Yang, Xu-Bao Liu, Bo-le Tian, Yi Zhang, Yi Ji","doi":"10.1016/j.pan.2025.09.034","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Continuing to use the 8th edition criteria, the current American Joint Committee on Cancer (AJCC) 9th staging system has been demonstrated to fail to distinguish prognosis in Stage I between Stage II for patients with G1/G2 pancreatic neuroendocrine tumors (p-NETs). A modified tumor-node-metastasis (mTNM) system with revised nodal classification was previously proposed, but hasn't been comprehensively validated by large-scale institutional studies.</p><p><strong>Methods: </strong>Data of eligible patients was retrospectively collected and distributed by the proposed mTNM staging system and the current AJCC 9th staging system. The staging characteristics for G1/G2/G3 p-NETs were respectively performed and compared by two systems.</p><p><strong>Results: </strong>Our study enrolled 310 patients with well-differentiated p-NETs, including 122 ones with G1, 132 with G2 and 56 with G3. The 5-year overall survival (OS) from AJCC Stage I to Stage IV was respectively 79.0 %, 88.8 %, 39.5 % and 15.8 %, in which survival comparison between Stage I and Stage II wasn't significant (P = 0.114). The OS at 5 years from mTNM Stage I to Stage IV was respectively 93.4 %, 75.5 %, 34.1 % and 15.8 %, in which notable survival differences were offered among each stage (P < 0.05). Moreover, consistent with the results of Akaike information criteria and Harrell's concordance index, the 95 % confidence intervals in multivariate analysis for proposed mTNM staging system were smaller than that of AJCC 9th staging system, indicating a more accurate predictive ability for the OS of G1/G2/G3 p-NETs.</p><p><strong>Conclusion: </strong>The proposed mTNM staging system was superior to the current AJCC 9th system for well-differentiated p-NETs.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Modified TNM staging system for well-differentiated pancreatic neuroendocrine tumors: A comparative study with the AJCC 9th edition.\",\"authors\":\"Min Yang, Jie-Yu Wen, Gui-Zhen Qian, Ting Yang, Xu-Bao Liu, Bo-le Tian, Yi Zhang, Yi Ji\",\"doi\":\"10.1016/j.pan.2025.09.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Continuing to use the 8th edition criteria, the current American Joint Committee on Cancer (AJCC) 9th staging system has been demonstrated to fail to distinguish prognosis in Stage I between Stage II for patients with G1/G2 pancreatic neuroendocrine tumors (p-NETs). A modified tumor-node-metastasis (mTNM) system with revised nodal classification was previously proposed, but hasn't been comprehensively validated by large-scale institutional studies.</p><p><strong>Methods: </strong>Data of eligible patients was retrospectively collected and distributed by the proposed mTNM staging system and the current AJCC 9th staging system. The staging characteristics for G1/G2/G3 p-NETs were respectively performed and compared by two systems.</p><p><strong>Results: </strong>Our study enrolled 310 patients with well-differentiated p-NETs, including 122 ones with G1, 132 with G2 and 56 with G3. The 5-year overall survival (OS) from AJCC Stage I to Stage IV was respectively 79.0 %, 88.8 %, 39.5 % and 15.8 %, in which survival comparison between Stage I and Stage II wasn't significant (P = 0.114). 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Modified TNM staging system for well-differentiated pancreatic neuroendocrine tumors: A comparative study with the AJCC 9th edition.
Background: Continuing to use the 8th edition criteria, the current American Joint Committee on Cancer (AJCC) 9th staging system has been demonstrated to fail to distinguish prognosis in Stage I between Stage II for patients with G1/G2 pancreatic neuroendocrine tumors (p-NETs). A modified tumor-node-metastasis (mTNM) system with revised nodal classification was previously proposed, but hasn't been comprehensively validated by large-scale institutional studies.
Methods: Data of eligible patients was retrospectively collected and distributed by the proposed mTNM staging system and the current AJCC 9th staging system. The staging characteristics for G1/G2/G3 p-NETs were respectively performed and compared by two systems.
Results: Our study enrolled 310 patients with well-differentiated p-NETs, including 122 ones with G1, 132 with G2 and 56 with G3. The 5-year overall survival (OS) from AJCC Stage I to Stage IV was respectively 79.0 %, 88.8 %, 39.5 % and 15.8 %, in which survival comparison between Stage I and Stage II wasn't significant (P = 0.114). The OS at 5 years from mTNM Stage I to Stage IV was respectively 93.4 %, 75.5 %, 34.1 % and 15.8 %, in which notable survival differences were offered among each stage (P < 0.05). Moreover, consistent with the results of Akaike information criteria and Harrell's concordance index, the 95 % confidence intervals in multivariate analysis for proposed mTNM staging system were smaller than that of AJCC 9th staging system, indicating a more accurate predictive ability for the OS of G1/G2/G3 p-NETs.
Conclusion: The proposed mTNM staging system was superior to the current AJCC 9th system for well-differentiated p-NETs.
期刊介绍：
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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