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Tumor burden score predicts tumor recurrence of non-functional pancreatic neuroendocrine tumors after curative resection.
HPB ( IF 2.9 ) Pub Date : 2019-12-09 , DOI: 10.1016/j.hpb.2019.11.009
Ding-Hui Dong 1 , Xu-Feng Zhang 2 , Alexandra G Lopez-Aguiar 3 , George Poultsides 4 , Eleftherios Makris 4 , Flavio Rocha 5 , Zaheer Kanji 5 , Sharon Weber 6 , Alexander Fisher 6 , Ryan Fields 7 , Bradley A Krasnick 7 , Kamran Idrees 8 , Paula M Smith 8 , Cliff Cho 9 , Megan Beems 9 , Carl R Schmidt 10 , Mary Dillhoff 10 , Shishir K Maithel 3 , Timothy M Pawlik 10
Affiliation  

Background

To investigate the feasibility of Tumor Burden Score (TBS) to predict tumor recurrence following curative-intent resection of non-functional pancreatic neuroendocrine tumors (NF-pNETs).

Method

The TBS cut-off values were determined by a statistical tool, X-tile. The influence of TBS on recurrence-free survival (RFS) was examined.

Results

Among 842 NF-pNETs patients, there was an incremental worsening of RFS as the TBS increased (5-year RFS, low, medium, and high TBS: 92.0%, 73.3%, and 59.3%, respectively; P < 0.001). TBS (AUC 0.74) out-performed both maximum tumor size (AUC 0.65) and number of tumors (AUC 0.5) to predict RFS (TBS vs. maximum tumor size, p = 0.05; TBS vs. number of tumors, p < 0.01). The impact of margin (low TBS: R0 80.4% vs. R1 71.9%, p = 0.01 vs. medium TBS: R0 55.8% vs. R1 37.5%, p = 0.67 vs. high TBS: R0 31.9% vs. R1 12.0%, p = 0.11) and nodal (5-year RFS, low TBS: N0 94.9% vs. N1 68.4%, p < 0.01 vs. medium TBS: N0 81.8% vs. N1 55.4%, p < 0.01 vs. high TBS: N0 58.0% vs. N1 54.2%, p = 0.15) status on 5-year RFS outcomes disappeared among patients who had higher TBS.

Conclusions

TBS was strongly associated with risk of recurrence and outperformed both tumor size and number alone.



中文翻译:

肿瘤负荷评分预测非功能性胰腺神经内分泌肿瘤在根治性切除术后的肿瘤复发。

背景

研究肿瘤负荷评分 (TBS) 预测非功能性胰腺神经内分泌肿瘤 (NF-pNETs) 根治性切除术后肿瘤复发的可行性。

方法

TBS 截止值由统计工具 X-tile 确定。检查了 TBS 对无复发生存期 (RFS) 的影响。

结果

在 842 名 NF-pNETs 患者中,随着 TBS 的增加,RFS 逐渐恶化(5 年 RFS,低、中和高 TBS:分别为 92.0%、73.3% 和 59.3%;P < 0.001  。TBS (AUC 0.74) 优于最大肿瘤大小 (AUC 0.65) 和肿瘤数量 (AUC 0.5) 来预测 RFS(TBS 与最大肿瘤大小,p = 0.05;TBS 与肿瘤数量,p  < 0.01) . 保证金的影响(低 TBS:R0 80.4% 对比 R1 71.9%,p  = 0.01 对比中等 TBS:R0 55.8% 对比 R1 37.5%,p  = 0.67 对比高 TBS:R0 31.9% 对比 R1 12.0% ,p  = 0.11)和节点(5 年 RFS,低 TBS:N0 94.9% 对比 N1 68.4%,p  < 0.01 对比中等 TBS:N0 81.8% 对比 N1 55.4%,p < 0.01 与高 TBS:N0 58.0% 与 N1 54.2%,p  = 0.15)在具有较高 TBS 的患者中,5 年 RFS 结果的状态消失。

结论

TBS 与复发风险密切相关,并且优于单独的肿瘤大小和数量。

更新日期:2019-12-09
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