High rate of Ki-67 increase in entero-pancreatic NET relapses after surgery with curative intent
McNamara, Mairead G
de Herder, W.
Valle, Juan W
Gress, T. M.
Pavel, M. E.
AffiliationDepartment of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
MetadataShow full item record
AbstractNeuroendocrine neoplasms (NENs) present with advanced disease at diagnosis in upto 28% of cases, precluding the possibility of curative-intent surgery. Histopathologi-cal heterogeneity of this disease can be observed inter-individually as well as intra-individually during disease course. The present study aimed to assess the frequencyof Ki-67 change after radical surgery, in a series of patients with radically resectedentero-pancreatic neuroendocrine tumors (EP-NETs).We present the analysis of a multicenter, retrospective, series of EP-NETs G1–G2recurring after radical resection and with histological re-evaluation at disease recur-rence (DR). The primary endpoint was the description of Ki-67 change at DR com-pared to time of surgery. The secondary endpoint was assessment of recurrence-freesurvival (RFS) rates. In total, 47 patients had a second histological evaluationand could be included in the present study. Median Ki-67 at surgery was 3% (range1–15%) but, at DR, a significant increase in the value was observed (7%, range1–30%;p< .01) and involved 66.0% of cases, with a corresponding increase in tumorgrading in 34.0% (p=.05). Median RFS of the overall population was 40 months, andwas worse when Ki-67 increased at DR vs. stable Ki-67 value (36 vs. 61 months espectively;p=.02). In conclusion, in more than half of the cases with relapse afterradical surgery, a higher proliferative index with a potentially more aggressive poten-tial was observed. Therefore, histological reassessment should be considered on DRbecause tailored therapeutic strategies may be required for these patients.
CitationMerola E, Perren A, Rinke A, Zerbi A, McNamara MG, Arsenic R, et al. High rate of Ki-67 increase in entero-pancreatic NET relapses after surgery with curative intent. Journal of neuroendocrinology. PubMed PMID: WOS:000843551700001.
JournalJournal of Neuroendocrinology