Evidence map›Paper›PMID 30353489›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019

A Prognostic Scoring System for the Prediction of Metastatic Recurrence Following Curative Resection of Pancreatic Neuroendocrine Tumors.

Shonan Sho, Colin M Court, Paul Winograd, Paul A Toste, Joseph R Pisegna, Michael Lewis, Timothy R Donahue, Oscar J Hines, Howard A Reber, David W Dawson and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Review
  4. Review
  5. Review
  6. Developing a Predictive Model for Metastatic Potential in Pancreatic Neuroendocrine Tumor.The Journal of clinical endocrinology and metabolism · 2024
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  18. Resection of pancreatic neuroendocrine tumors: defining patterns and time course of recurrence.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shonan ShoDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA. ssho@mednet.ucla.edu.ORCID 0000-0002-1547-6402
Colin M CourtDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
Paul WinogradDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
Paul A TosteDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
Joseph R PisegnaDivision of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90095, USA.
Michael LewisDepartment of Pathology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA.
Timothy R DonahueDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
Oscar J HinesDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
Howard A ReberDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.
David W DawsonDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
James S TomlinsonDepartment of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA.

Funding

Women's CancersP30CA016042 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Samuel Wheeler French · 1985 to 2026
$134.5M
Pilot and Feasibility ProgramP30DK041301 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ROZENGURT, JUAN ENRIQUE · 1990 to 2019
$18.0M
GASTROENTEROLOGYT32DK007180 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JENSEN, DENNIS MICHAEL · 1986 to 2025
$10.0M
Gastrointestinal Hormonal Regulation of ObesityI01RX000194 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI PISEGNA, JOSEPH R, TACHE, YVETTE FRANCE · 2012 to 2015
–
NCI NIH HHS P30 CA016042NIDDK NIH HHS P30 DK041301NIDDK NIH HHS T32 DK007180RRD VA I01 RX000194
6 · The paper itself

Abstract

backgroundPatients with early-stage pancreatic neuroendocrine tumors (PNETs) may develop metastatic recurrences despite undergoing potentially curative pancreas resections. We sought to identify factors predictive of metastatic recurrences and develop a prognostication strategy to predict recurrence-free survival (RFS) in resected PNETs.

methodsPatients with localized PNETs undergoing surgical resection between 1989 and 2015 were identified. Univariate and multivariate analysis were used to identify potential predictors of post-resection metastasis. A score-based prognostication system was devised using the identified factors. The bootstrap model validation methodology was utilized to estimate the external validity of the proposed prognostication strategy.

resultsOf the 140 patients with completely resected early-stage PNETs, overall 5- and 10-year RFS were 84.6% and 67.1%, respectively. The median follow-up was 56 months. Multivariate analysis identified tumor size > 5 cm, Ki-67 index 8-20%, lymph node involvement, and high histologic grade (G3, or Ki-67 > 20%) as independent predictors of post-resection metastatic recurrence. A scoring system based on these factors stratified patients into three prognostic categories with distinct 5-year RFS: 96.9%, 54.8%, and 33.3% (P < 0.0001). The bootstrap model validation methodology projected our proposed prognostication strategy to retain a high predictive accuracy even when applied in an external dataset (validated c-index of 0.81).

conclusionsThe combination of tumor size, LN status, grade, and Ki-67 was identified as the most highly predictive indicators of metastatic recurrences in resected PNETs. The proposed prognostication strategy may help stratify patients for adjuvant therapies, enhanced surveillance protocols and future clinical trials.

Indexed as

AdultAgedDisease-Free SurvivalFemaleHumansKi-67 AntigenLymphatic MetastasisMaleMiddle AgedMultivariate AnalysisNeoplasm GradingNeuroendocrine TumorsPancreatectomyPancreatic NeoplasmsPrognosisRecurrenceKi-67 AntigenNeoplasm recurrenceNeuroendocrine tumorsPancreasSurgical oncology

Identifiers

PMID30353489
PMCPMC6736531

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.