title: Prognostic Validity of the American Joint Committee on Cancer and the European Neuroendocrine Tumors Staging Classifications for Pancreatic Neuroendocrine Tumors: A Retrospective Nationwide Multicenter Study in South Korea.
abstract: Pancreatic neuroendocrine tumors (pNETs) are diverse diseases with different prognosis. The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) introduced 2 different tumor node metastasis (TNM) stages, and the World Health Organization (WHO) proposed WHO 2010 grading system for pNETs. Therefore, we aimed to validate the prognostic relevance of these 3 systems for pNETs in South Korea.
  
  
  
  The Korean Society of Gastrointestinal Cancer created a retrospective registry of pNETs in 153 patients from 15 hospitals between 2002 and 2012.
  
  
  
  On the basis of the WHO 2010 grade, 2-year progression-free-survival (PFS) rates for G1, G2, and G3 were 92%, 62%, and 25% (P < 0.01). According to ENETS and AJCC staging, 2-year PFS rates for stages I through IV were 94%, 87%, 49%, 20%, and 92%, 61%, 60%, 20%, respectively (P < 0.01). A Cox multivariate regression analysis revealed that the only statistically significant prognostic factor was the TNM classification of either the AJCC or the ENETS stage (P < 0.01). In addition, the κ value between the AJCC and the ENETS stages was 0.46 indicating a "moderate" agreement (P < 0.01).
  
  
  
  The AJCC and ENETS TNM classifications for pNETs are prognostic for PFS and can be adopted in clinical practice in South Korea.
authors.affiliation: From the *Department of Internal Medicine, Gachon University Gil Medical Center, Incheon; †Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul; ‡Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul; §Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang; ∥Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; ¶Center for Liver Cancer, National Cancer Center, Goyang; #Department of Internal Medicine, Chonnam National University Medical School, Gwangju; **Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon; ††Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Jeonju; ‡‡Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang; §§Department of Internal Medicine, Konkuk University School of Medicine, Seoul; ∥∥Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu; ¶¶Department of Internal Medicine, Yeungnam University College of Medicine, Daegu; ##Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang; ***Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang; †††Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju; ‡‡‡Department of Internal Medicine, Kosin University School of Medicine, Busan; §§§Department of Internal Medicine, Ajou University School of Medicine, Suwon; ∥∥∥Department of Internal Medicine, Wonkwang University College of Medicine, Iksan; ¶¶¶Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul; ###Department of Internal Medicine, Kyungpook National University College of Medicin
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cho
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Dong Ki
authors.initials: DK
authors.lastname: Lee
authors.forename: Sang Myung
authors.initials: SM
authors.lastname: Woo
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Seok
authors.initials: S
authors.lastname: Jeong
authors.forename: Seung-Ok
authors.initials: SO
authors.lastname: Lee
authors.forename: Byung Kyu
authors.initials: BK
authors.lastname: Park
authors.forename: Young Koog
authors.initials: YK
authors.lastname: Cheon
authors.forename: Jimin
authors.initials: J
authors.lastname: Han
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
authors.forename: Jun Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Moon
authors.forename: Hyunjin
authors.initials: H
authors.lastname: Kim
authors.forename: Eun Taek
authors.initials: ET
authors.lastname: Park
authors.forename: Jae Chul
authors.initials: JC
authors.lastname: Hwang
authors.forename: Tae Hyeon
authors.initials: TH
authors.lastname: Kim
authors.forename: Tae Joo
authors.initials: TJ
authors.lastname: Jeon
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Cho
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Choi
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000574:American Medical Association; D002648:Child; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000145:classification / Q000473:pathology*; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000145:classification / Q000473:pathology*; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D056910:Republic of Korea; D012189:Retrospective Studies; D014481:United States; D014944:World Health Organization; D055815:Young Adult