Merola, Elettra; Perren, Aurel; Rinke, Anja; Zerbi, Alessandro; McNamara, Mairéad G; Arsenic, Ruza; Fazio, Nicola; de Herder, Wouter; Valle, Juan W; Gress, Thomas M; Wiedenmann, Bertram; Pascher, Andreas; Pavel, Marianne E (2022). High rate of Ki-67 increase in entero-pancreatic NET relapses after surgery with curative intent. Journal of neuroendocrinology, 34(10), e13193. Wiley-Blackwell 10.1111/jne.13193
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Neuroendocrine neoplasms (NENs) present with advanced disease at diagnosis in up to 28% of cases, precluding the possibility of curative-intent surgery. Histopathological heterogeneity of this disease can be observed inter-individually as well as intra-individually during disease course. The present study aimed to assess the frequency of Ki-67 change after radical surgery, in a series of patients with radically resected entero-pancreatic neuroendocrine tumors (EP-NETs). We present the analysis of a multicenter, retrospective, series of EP-NETs G1-G2 recurring after radical resection and with histological re-evaluation at disease recurrence (DR). The primary endpoint was the description of Ki-67 change at DR compared to time of surgery. The secondary endpoint was assessment of recurrence-free survival (RFS) rates. In total, 47 patients had a second histological evaluation and could be included in the present study. Median Ki-67 at surgery was 3% (range 1-15%) but, at DR, a significant increase in the value was observed (7%, range 1-30%; p < .01) and involved 66.0% of cases, with a corresponding increase in tumor grading in 34.0% (p = .05). Median RFS of the overall population was 40 months, and was worse when Ki-67 increased at DR vs. stable Ki-67 value (36 vs. 61 months, respectively; p = .02). In conclusion, in more than half of the cases with relapse after radical surgery, a higher proliferative index with a potentially more aggressive potential was observed. Therefore, histological reassessment should be considered on DR because tailored therapeutic strategies may be required for these patients.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute of Pathology |
UniBE Contributor: |
Perren, Aurel |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
0953-8194 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
31 Oct 2022 12:25 |
Last Modified: |
05 Dec 2022 16:27 |
Publisher DOI: |
10.1111/jne.13193 |
PubMed ID: |
36306194 |
Uncontrolled Keywords: |
Ki-67 change disease recurrence entero-pancreatic neuroendocrine tumors heterogeneity radical surgery |
BORIS DOI: |
10.48350/174248 |
URI: |
https://boris.unibe.ch/id/eprint/174248 |