title: The importance of clinical information in patients with gastroenteropancreatic neuroendocrine tumor.
abstract: OBJECTIVE
  The WHO 2010 grading system for gastroenteropancreatic neuroendocrine tumors(GEP-NETs) is used to evaluate the malignant potential without clinicopathological information. This study was conducted to examine whether the new index is superior to the previous WHO 2004 classification, e.g.for well-differentiated endocrine carcinoma (WEC),involving clinical information.
  
  
  METHODS
  Between 2000 and 2011, 77 patients with sporadic GEP-NETs were treated at our institution and statistically estimated risk factors for overall survival (OS) were evaluated. Cox proportional hazards regression analyses were performed to estimate risk factors for OS.
  
  
  RESULTS
  Overall 1-, 3- and 5-year survival rates were 92.8%, 78.4% and 76.0%, respectively. Median OS was 551 days in WEC-patients (odds ratio (OR)for OS=13.1, 95% confidence interval (CI)=2.90-59.5;p=0.001). The median OS was 813 days in G3-patients as compared with 1885 days in G1/G2-patients(OR for OS= 2.64, p=0.002). Multivariate analyses according to baseline characteristics revealed WEC as independent risk factor (OR=9.06, p=0.01). WEC was the only predictor of prognosis with an area under the receiver operating characteristic curves of 0.78(p=0.001).
  
  
  CONCLUSIONS
  Clinical information was the best predictor for the prognosis of NETs.
authors.affiliation: Department of Hepatobiliary-Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan. kudomsrg@tmd.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kudo
authors.forename: Takumi
authors.initials: T
authors.lastname: Akashi
authors.forename: Jiro
authors.initials: J
authors.lastname: Kumagai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ban
authors.forename: Mikito
authors.initials: M
authors.lastname: Inokuchi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kojima
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kawano
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002454:Cell Differentiation; D049109:Cell Proliferation; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007414:Intestinal Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D016019:Survival Analysis; D013997:Time Factors; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor