ArticleAnnals of surgical oncology2017
Increased Grade in Neuroendocrine Tumor Metastases Negatively Impacts Survival.
Article in Annals of surgical oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- GEP-NET radiomics: a systematic review and radiomics quality score assessment.European radiology · 2022Pooled it
- Article
- Diagnostic Utility of Ki-67 Index on Cell Block Material for Grading Medullary Thyroid Carcinoma.Diagnostic cytopathology · 2026Article
- Clinical Implications of Ki-67 Index, Grade and Hormonal Changes in Pancreatic Neuroendocrine Tumors: Insights Into Tumor Heterogeneity Based on Primary and Secondary Lesions.Journal of hepato-biliary-pancreatic sciences · 2026Article
- Solitary left frontotemporal neuroendocrine metastasis mimicking a high-grade astrocytoma.Surgical neurology international · 2026Article
- Computed tomography-guided percutaneous biopsy for assessing tumor heterogeneity in neuroendocrine tumor metastases to the liver.World journal of radiology · 2025Article
- Factors associated with grade progression in pancreatic neuroendocrine tumors.Endocrine-related cancer · 2025Article
- Surgical cytoreduction versus systemic therapy in patients with metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NENS): a national cancer database analysis (NCDB).Oncology reviews · 2025Article
- Liver transplantation for gastroenteropancreatic neuroendocrine liver metastasis: optimal patient selection and perioperative management in the era of multimodal treatments.Journal of gastroenterology · 2025Review
- The University of Iowa Neuroendocrine Tumor Clinic.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025Article
- Rapid Evolution of Metastases in Patients with Treated G3 Neuroendocrine Tumors Associated with NEC-Like Transformation and TP53 Mutation.Endocrine pathology · 2024Article
- Neuroendocrine tumor liver metastasis: moderate long-term outcomes supporting ablation.Surgical endoscopy · 2024Article
- Article
- Predictors of Long-Term Outcomes After Liver Transplantation for Unresectable Metastatic Neuroendocrine Tumors.Annals of transplantation · 2023Article
- Review
- Article
- Review
- Frequency and Prognostic Significance of Intertumoural Heterogeneity in Multifocal Jejunoileal Neuroendocrine Tumours.Cancers · 2022Article
- The overriding role of surgery and tumor grade for long-term survival in patients with gastroenteropancreatic neuroendocrine neoplasms: A population-based cohort study.Cancer reports (Hoboken, N.J.) · 2022Observational
- A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival.Frontiers in endocrinology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundTumor grade is an important predictor of survival in gastroenteropancreatic (GEP) neuroendocrine tumors (NETs), as determined by Ki-67 expression and mitotic rate. NETs generally grow indolently, but some cells may acquire traits facilitating metastasis. It is unclear how frequently metastases differ in grade from their primary tumors, and whether increasing grade in metastases affects prognosis.
methodsKi-67 immunohistochemistry was performed on resected GEPNET specimens and cases with results for both primary tumors and concurrent metastases were identified. Grade was determined using a modified World Health Organization classification (Ki-67: G1 = 0-2%; G2 > 2-20%; G3 > 20%).
resultsKi-67 was performed on both the primary tumor and metastases in 103 patients. Tumor grade was higher in metastases from 25 (24%) patients, 24 increased from G1 to G2, and 1 increased from G2 to G3; 68 (66%) patients had no change in grade (42 G1 and 26 G2), and 10 (10%) decreased from G2 to G1. No clinicopathologic factors were predictive of higher grade in metastases. The 5-year progression-free survival (PFS) was 55% for patients with stable grade versus 8% of patients with increased grade, while 5-year overall survival (OS) was 92 and 54%, respectively. The 5-year OS of patients who had stable grade with G1 and G2 primaries was 92 and 64%, respectively.
conclusionsNearly one-third of patients had metastases with a different grade than their primary, and, when grade increased, both PFS and OS significantly decreased. Determining the grade in both the primary tumor and a metastasis is important for estimating prognosis and to help inform decisions regarding additional therapies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.