title: Survival prognostic factors of gastro-enteric-pancreatic neuroendocrine tumors after primary tumor resection in a single tertiary center: Comparison of gastro-enteric and pancreatic locations.
abstract: OBJECTIVE
  This study aimed to evaluated prognostic factors of patients with GEP-NETs after primary tumor resection comparing pancreatic and gastro-enteric locations.
  
  
  METHODS
  Patients undergone surgery for primary GEP-NETs between 01/2000 and 03/2012 were considered. All specimens were reclassified according to the WHO 2010 scheme.
  
  
  RESULTS
  A total of 83 patients were considered: 37 pancreatic NETs (pNET) and 46 gastroenteric NETs (GE-NET). The two groups were similar in terms of age, sex and tumors size. A higher rate of patients with pNETs had Ki67 score ≥3 (64.8% vs. 39%, p = 0.027) while the rates of Mitotic Index ≥2x10HPF (62% pNET vs. 50% GE-NET, p = 0.374) and diagnosis of neuroendocrine carcinoma NEC (16.2% pNET vs. 17.3% GE-NET, p = 0.100) were similar. The rates of distant metastases (GE-NETs 30.4% vs. p-NETs 29.7%, p = 0.944) and liver metastases (19.5% GE-NET vs. 27% pNET, p = 0.421) were comparable. Radical resection was achieved in a similar proportion in both groups [33 patients (89.1%) pNET vs. 36 (78.2%) GE-NET, p = 0.393]. After a median follow-up of 47.1 months overall 3, 5 and 10-years survival rates of whole patients were 88.1%, 81.2% and 76.7%. There was not difference on 5-years overall survival between pNET (81.4%) and GE-NET (81%, p = 0.901). At multivariate analysis age ≥70 [OR 4.177 (CI 95% 1.26-13.8), p = 0.019] and NEC [OR 5.932 (CI 95% 1.81-19.40), p < 0.001] were negative prognostic factors of survival.
  
  
  CONCLUSIONS
  Overall survival of GEP-NET after resection of primary tumors seems to be correlated to patient's age and WHO 2010 staging system but not to primary tumor site.
authors.affiliation: Department of General and Oncological Surgery, Ospedale Mauriziano, Torino, Italy. Electronic address: nadia.russolillo@libero.it.
authors.forename: N
authors.initials: N
authors.lastname: Russolillo
authors.affiliation: Department of Surgery, Liver Surgery Unit, Humanitas Clinical and Research Center, Milan, Rozzano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Vigano'
authors.affiliation: Unit of Endocrinology, Ospedale Mauriziano, Torino, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Razzore
authors.affiliation: Department of General and Oncological Surgery, Ospedale Mauriziano, Torino, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Langella
authors.affiliation: Unit of Endocrinology, Ospedale Mauriziano, Torino, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Motta
authors.affiliation: Department of General and Oncological Surgery, Ospedale Mauriziano, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bertuzzo
authors.affiliation: Division of Pathology, Ospedale Mauriziano, Torino, Italy; Department of Oncology, University of Turin, Torino Italy.
authors.forename: M
authors.initials: M
authors.lastname: Papotti
authors.affiliation: Department of General and Oncological Surgery, Ospedale Mauriziano, Torino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ferrero
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008113:Liver Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000556:secondary / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D062606:Tertiary Care Centers
chemical_list: D019394:Ki-67 Antigen
keywords: Gastro-enteric neuroendocrine tumors; Overall survival; Pancreatic neuroendocrine tumors; Surgery