title: Value of both WHO and TNM classification systems for patients with pancreatic endocrine tumors: results of a single-center series.
abstract: OBJECTIVE
  This study was designed to evaluate the clinical relevance of the World Health Organization (WHO) and tumor node metastasis (TNM) classifications in patients affected by pancreatic endocrine tumors.
  
  
  METHODS
  Data from 76 consecutive patients with pancreatic endocrine tumors who underwent surgery were analyzed.
  
  
  RESULTS
  Well-differentiated tumors were observed more frequently (57.9%) than well or poorly differentiated carcinomas (26.3% and 15.8%, respectively). The TNM stage was I in 27.6%, II in 39.5%, III in 19.7%, and IV in 13.2%. Univariate analysis of disease-specific survival showed that patients with stages I-II had a significantly better survival rate than those with stages III-IV (hazard ratio (HR), 12.46; 95% confidence interval (CI), 1.53-101.32; P = 0.018; HR, 25.74; 95% CI, 3.07-216.07; P = 0.003, respectively). Regarding the WHO classification, poorly differentiated carcinomas had the worst prognosis (HR, 79.13; 95% CI, 9.99-626.60; P < 0.001). Multivariate Cox regression analysis of disease-specific survival showed that the WHO classification is the only independent factors of improved survival: both poorly and well-differentiated carcinomas had an increased risk of death compared with WDTs (HR, 100.42; 95% CI, 12.16-829.40; P < 0.001; HR, 10.73; 95% CI, 1.12-104.17; P = 0.040, respectively). TNM classification and the WHO system are highly correlated (P < 0.001).
  
  
  CONCLUSIONS
  TNM stage and the WHO classification seems to be equally reliable, even if TNM classification tends to understage the patients classified using the WHO system.
authors: Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138 Bologna, Italy. riccardo.casadei@aosp.bo.it
authors: Riccardo
authors: R
authors: Casadei
authors: Claudio
authors: C
authors: Ricci
authors: Raffaele
authors: R
authors: Pezzilli
authors: Davide
authors: D
authors: Campana
authors: Paola
authors: P
authors: Tomassetti
authors: Lucia
authors: L
authors: Calculli
authors: Donatella
authors: D
authors: Santini
authors: Nicola
authors: N
authors: Antonacci
authors: Francesco
authors: F
authors: Minni
mesh_terms: D004701:Endocrine Gland Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies