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Value of Both WHO and TNM Classification Systems for Patients with Pancreatic Endocrine Tumors: Results of a Single-Center Series

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Abstract

Objectives

This study was designed to evaluate the clinical relevance of the World Health Organization (WHO) and tumor node metastasis (TNM) classifications in patients affected by pancreatic endocrine tumors.

Methods

Data from 76 consecutive patients with pancreatic endocrine tumors who underwent surgery were analyzed.

Results

Well-differentiated tumors were observed more frequently (57.9%) than well or poorly differentiated carcinomas (26.3% and 15.8%, respectively). The TNM stage was I in 27.6%, II in 39.5%, III in 19.7%, and IV in 13.2%. Univariate analysis of disease-specific survival showed that patients with stages I–II had a significantly better survival rate than those with stages III–IV (hazard ratio (HR), 12.46; 95% confidence interval (CI), 1.53–101.32; P = 0.018; HR, 25.74; 95% CI, 3.07–216.07; P = 0.003, respectively). Regarding the WHO classification, poorly differentiated carcinomas had the worst prognosis (HR, 79.13; 95% CI, 9.99–626.60; P < 0.001). Multivariate Cox regression analysis of disease-specific survival showed that the WHO classification is the only independent factors of improved survival: both poorly and well-differentiated carcinomas had an increased risk of death compared with WDTs (HR, 100.42; 95% CI, 12.16–829.40; P < 0.001; HR, 10.73; 95% CI, 1.12–104.17; P = 0.040, respectively). TNM classification and the WHO system are highly correlated (P < 0.001).

Conclusions

TNM stage and the WHO classification seems to be equally reliable, even if TNM classification tends to understage the patients classified using the WHO system.

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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy

    Riccardo Casadei, Claudio Ricci, Nicola Antonacci & Francesco Minni

  2. Dipartimento di Medicina Interna e Gastroenterologia, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy

    Raffaele Pezzilli, Davide Campana & Paola Tomassetti

  3. Dipartimento di Scienze Radiologiche e Istocitopatologiche, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy

    Lucia Calculli & Donatella Santini

Authors
  1. Riccardo Casadei
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  2. Claudio Ricci
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  3. Raffaele Pezzilli
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  4. Davide Campana
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  5. Paola Tomassetti
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  6. Lucia Calculli
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  7. Donatella Santini
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  8. Nicola Antonacci
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  9. Francesco Minni
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Correspondence to Riccardo Casadei.

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Casadei, R., Ricci, C., Pezzilli, R. et al. Value of Both WHO and TNM Classification Systems for Patients with Pancreatic Endocrine Tumors: Results of a Single-Center Series. World J Surg 33, 2458–2463 (2009). https://doi.org/10.1007/s00268-009-0182-4

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  • DOI: https://doi.org/10.1007/s00268-009-0182-4

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