scholarly journals LGG-07. IS BRAF ALTERATION OR A HISTOLOGIC ‘QUALIFIER’ A PREDICTOR OF OUTCOME IN PEDIATRIC PILOCYTIC ASTROCYTOMA?

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i32-i32
Author(s):  
Samuel J Cler ◽  
Alexander Skidmore ◽  
Alexander T Yahanda ◽  
Ali Mian ◽  
Kimberly Mackey ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Pilocytic Astrocytoma ◽  
Fourth Ventricle ◽  
Survival Rates ◽  
Point Mutations ◽  
Extent Of Resection ◽  
Tumor Location ◽  
Central Nervous System Tumor ◽  
Ki 67 ◽  
Who Grade

Abstract Introduction Pediatric pilocytic astrocytomas (PA) are the most common pediatric central nervous system tumor. Surgical resection is the primary treatment for PA with five-year survival rates up to 95%. Despite a favorable prognosis, our understanding about the prognostic value of histopathological findings, such as histopathologic qualifier* or BRAF alterations is evolving. Methods Patients treated for a WHO grade 1 PA at Washington University in St. Louis/St. Louis Children’s Hospital were analyzed for clinical details, including pathology diagnosis (*histopathologic qualifier refers to designations in the diagnosis such as “WHO Grade I pilocytic astrocytoma with increased proliferative index”). BRAF alterations include gene fusions and point mutations. Results 224 patients were analyzed (51% female, mean age 9.6 years). Tumors were located in the cerebellum/fourth ventricle (50%), optic pathway/hypothalamus (15%), brainstem (12%), and cerebral cortex (11%). BRAF alterations were identified in 55/77 patients (71.4%) and additional histopathologic qualifiers were present in 27/220 patients (12.3%). 196 patients (87.5%) underwent surgical treatment and 22 (9.8%) had biopsy alone. 45 patients (22%) displayed tumor progression or recurrence after resection. The presence of a histopathologic ‘qualifier’ in the topline or BRAF alteration was not associated with tumor progression or recurrence (p=0.36, p=0.77). Ki-67 proliferative indices were not predictive of progression or recurrence (p=0.94), including when controlling for extent of resection and adjuvant therapy. BRAF alterations, specifically KIAA1549 fusions, were associated with cerebellar/fourth ventricular tumor location (p<0.001) and younger patient age (p=0.03). Extent of resection was the only predictor of outcome identified in this study; patients with gross total resection had significantly lower rates of progression and recurrence (p<0.0001). Conclusion BRAF alterations and histopathologic qualifiers were not associated with tumor progression or recurrence in pediatric PA, although BRAF fusions were more common in tumors located in the cerebellum/fourth ventricle and in younger patients.

scholarly journals Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Patients With Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuki Kuranari ◽  
Ryota Tamura ◽  
Noboru Tsuda ◽  
Kenzo Kosugi ◽  
Yukina Morimoto ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Laboratory Data ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Tumor Location ◽  
Neutrophil To Lymphocyte Ratio ◽  
Ki 67 ◽  
Who Grade ◽  
Lymphocyte Ratio ◽  
Subtotal Removal

BackgroundMeningiomas are the most common benign intracranial tumors. However, even WHO grade I meningiomas occasionally show local tumor recurrence. Prognostic factors for meningiomas have not been fully established. Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic factor for several solid tumors. The prognostic value of NLR in meningiomas has been analyzed in few studies.Materials and MethodsThis retrospective study included 160 patients who underwent surgery for meningiomas between October 2010 and September 2017. We analyzed the associations between patients’ clinical data (sex, age, primary/recurrent, WHO grade, extent of removal, tumor location, peritumoral brain edema, and preoperative laboratory data) and clinical outcomes, including recurrence and progression-free survival (PFS).ResultsForty-four meningiomas recurred within the follow-up period of 3.8 years. WHO grade II, III, subtotal removal, history of recurrence, Ki-67 labeling index ≥3.0, and preoperative NLR value ≥2.6 were significantly associated with shorter PFS (P < 0.001, < 0.001, 0.002, < 0.001, and 0.015, respectively). Furthermore, NLR ≥ 2.6 was also significantly associated with shorter PFS in a subgroup analysis of WHO grade I meningiomas (P = 0.003). In univariate and multivariate analyses, NLR ≥2.6 remained as a significant predictive factor for shorter PFS in patients with meningioma (P = 0.014).ConclusionsNLR may be a cost-effective and novel preoperatively usable biomarker in patients with meningiomas.

scholarly journals Establishment of age group classification for risk stratification in glioma patients

2020 ◽  
Author(s):  
Zhiying Lin ◽  
Runwei Yang ◽  
Yawei Liu ◽  
Kaishu Li ◽  
Guozhong Yi ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Risk Stratification ◽  
Tumor Size ◽  
Age Groups ◽  
Tumor Location ◽  
Group Classification ◽  
Age Group ◽  
Ki 67 ◽  
Who Grade ◽  
Age Group Classification

Abstract Objective: Age is associated with the prognosis of glioma patients, but there is no uniform standard of age-group classification to evaluate the prognosis of glioma patients. In this study, we aimed to establish an age group classification for risk stratification in glioma patients. Methods: A total of 1502 patients diagnosed with gliomas at Nanfang Hospital between 2000 and 2018 were enrolled. The WHO grade of glioma was used as a dependent variable to evaluate the effect of age on risk stratification. The evaluation model was established by logistic regression, and the Akaike information criterion (AIC) value of the model was used to determine the optimal cutoff points for age-classification. The differences in gender, WHO grade, pathological subtype, tumor cell differentiation direction, tumor size, tumor location, and molecular markers between different age groups were analyzed. The molecular markers included GFAP, EMA, MGMT, p53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, 1p/19q, PR, CD3, H3K27M, and TS. Results: The proportion of men with glioma was higher than that of women with glioma (58.3% vs 41.7%). Analysis of age showed that appropriate classifications of age group were 0-14 years old (pediatric group), 15-47 years old (youth group), 48-63 years old (middle-aged group), and ≥64 years old (elderly group).The proportions of glioblastoma and large tumor size (4-6 cm) increased with age (p = 0.000, p = 0.018, respectively ). Analysis of the pathological molecular markers across the four age groups showed that the proportion of patients with larger than 10% area of Ki-67 expression or positive PR expression increased with age (p = 0.000, p = 0.017, respectively). Conclusion: Age was effective evaluating the risk of glioblastoma in glioma patients. Appropriate classifications of age group for risk stratification were 0-14 years old (pediatric group), 15-47 years old (young group), 48-63 years old (middle age group) and ≥ 64 years old (elderly group). There was significant heterogeneity in WHO grade, tumor size, tumor location and some molecular markers among the four age groups.

A proposed classification system that projects outcomes based on preoperative variables for adult patients with glioblastoma multiforme

2010 ◽  
Vol 112 (5) ◽  
pp. 997-1004 ◽  
Author(s):  
Kaisorn Chaichana ◽  
Scott Parker ◽  
Alessandro Olivi ◽  
Alfredo Quiñones-Hinojosa
Keyword(s):  
Performance Status ◽  
Survival Rates ◽  
Extent Of Resection ◽  
Tumor Location ◽  
Motor Deficit ◽  
Grading System ◽  
Factors Associated ◽  
Adjuvant Therapies ◽  
Language Deficit ◽  
Preoperative Factors

Object Glioblastoma multiforme (GBM) is the most common and aggressive type of primary brain tumor in adults. Although the average survival is ~ 12 months, individual survival is heterogeneous. The ability to predict short- and long-term survivors is limited. Therefore, the aims of this study were to ascertain preoperative risk factors associated with survival, develop a preoperative prognostic grading system, and evaluate the utility of this grading system in predicting survival for patients undergoing resection of a primary intracranial GBM. Methods Cases involving adult patients who underwent surgery for an intracranial primary (de novo) GBM between 1997 and 2007 at The Johns Hopkins Hospital, an academic tertiary-care institution, were retrospectively reviewed. Multivariate proportional hazards regression analysis was used to identify preoperative factors associated with survival, after controlling for extent of resection and adjuvant therapies. The identified associations with survival were then used to develop a grading system based on preoperative variables. Survival as a function of time was plotted using the Kaplan-Meier method, and survival rates were compared using Log-rank analysis. Associations with p < 0.05 were considered statistically significant. Results Of the 393 patients in this study, 310 (79%) had died as of most recent follow-up (median time from surgery to death 11.9 months). The preoperative factors, independent of extent of resection and adjuvant therapies (carmustine wafers, temozolomide, and radiation), found to be negatively associated with survival were: age > 60 years (p < 0.0001), Karnofsky performance status score ≤ 80 (p < 0.0001), motor deficit (p = 0.02), language deficit (p = 0.001), and periventricular tumor location (p = 0.04). Patients possessing 0–1, 2, 3, and 4–5 of these variables were assigned a preoperative grade of 1, 2, 3, and 4, respectively. Patients with a preoperative grade of 1, 2, 3, and 4 had a median survival of 16.6, 10.2, 6.8, and 6.1 months, respectively. Conclusions The present study found that older age, poor performance status, motor deficit, language deficit, and periventricular tumor location independently predicted poorer survival in patients undergoing GBM resection. A grading system based on these factors was able to identify 4 distinct groups of patients with different survival rates. This grading system, based only on preoperative variables, may provide patients and physicians with prognostic information that may guide medical and surgical therapy before any intervention is pursued.

scholarly journals The Simpson grade: abandon the scale but preserve the message

2020 ◽  
pp. 1-8
Author(s):  
Theodore H. Schwartz ◽  
Michael W. McDermott
Keyword(s):  
Visual Assessment ◽  
Extent Of Resection ◽  
Tumor Location ◽  
Fluorescent Labeling ◽  
Recurrence Rates ◽  
Who Grade ◽  
Single Measure ◽  
Postoperative Mri ◽  
Simpson Grade ◽  
Meningioma Surgery

The Simpson grading scale, developed in 1957 by Donald Simpson, has been considered the gold standard for defining the surgical extent of resection for WHO grade I meningiomas. Since its introduction, the scale and its modifications have generated enormous controversy. The Simpson grade is based on an intraoperative visual assessment of resection, which is subjective and notoriously inaccurate. The majority of studies in which the grading system was used were performed before routine postoperative MRI surveillance was employed, rendering assessments of extent of resection and the definition of recurrence inconsistent. The infiltration and proliferation potential of tumor components such as hyperostotic bone and dural tail vary widely based on tumor location, as does the molecular biology of the tumor, rendering a universal scale for all meningiomas unfeasible. While extent of resection is clearly important at reducing recurrence rates, achieving the highest Simpson grade resection should not always be the goal of surgery.Donald Simpson’s name and his scale deserve to be recognized and preserved in the historical pantheon of pioneering and transformative neurosurgical concepts. Nevertheless, his eponymous scale is no longer relevant in modern meningioma surgery. While his message of maximizing extent of resection and minimizing morbidity is still germane, a single measure using subjective criteria cannot be applied universally to all meningiomas, regardless of location. Meningioma surgery should be performed with the goal of achieving maximal safe resection, ideally guided by molecularly tagged fluorescent labeling and assessed using objective criteria, including postoperative MRI as well as molecularly tagged scans such as [68Ga]-DOTATATE-PET.

scholarly journals Meningiomas in Premenopausal Women: Role of the Hormone Related Conditions

2020 ◽  
Vol 10 ◽  
Author(s):  
Francesco Maiuri ◽  
Giuseppe Mariniello ◽  
Teresa Somma ◽  
Elia Guadagno ◽  
Sergio Corvino ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Premenopausal Women ◽  
Tumor Location ◽  
Biological Behavior ◽  
Pathological Findings ◽  
Ki 67 ◽  
Who Grade ◽  
Female Sex Hormones ◽  
Significant Difference

BackgroundSeveral epidemiological and pathological findings suggest that the female sex hormones may influence the development of meningiomas. However, the role of pregnancy, oral contraceptives, and fertilization therapies is still controversial.MethodsFrom the surgical series of 354 patients with meningiomas operated between 2006 and 2019, the group of 72 premenopausal women was separately considered. The tumor location, WHO grade, Ki67-labeling index (LI), progesterone receptor (PR) expression, and histological types were studied in premenopausal women with and without hormone-related conditions were compared.ResultsIn this premenopausal group, 24 patients had hormone-related conditions, including use of oral contraceptives in 16, intrauterine fertilization in one, pregnancy in three, and tumors of the female reproductive system in four. The group of patients with hormone-related conditions, as compared to that with no hormone related conditions, showed slightly lower median age (38 versus 43 years) and no significant difference of meningioma location WHO grade, Ki 67-Li, PR expression and histological type. The clinical onset during pregnancy in three patients and tumor growth during contraceptive progesterone therapy in two others were evidenced.ConclusionThe biological behavior of meningiomas and their pathological findings, including PR expression, are not correlated with the different hormone related conditions in premenopausal female patients. Contraceptives and fertilization therapies, mainly with progesterone, should be avoided in patients with meningiomas.

Study of the MIB-1 Labeling Index as a Predictor of Tumor Progression in Pilocytic Astrocytomas in Children and Adolescents

2003 ◽  
Vol 21 (15) ◽  
pp. 2968-2973 ◽  
Author(s):  
Daniel C. Bowers ◽  
Lynn Gargan ◽  
Payal Kapur ◽  
Joan S. Reisch ◽  
Arlynn F. Mulne ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Initial Study ◽  
Tumor Location ◽  
Labeling Index ◽  
Rank Analysis ◽  
Complete Surgical Resection ◽  
Optic Pathways ◽  
Mib 1

Purpose: The pilocytic astrocytoma (PA) is the most common childhood brain tumor. This report examines the MIB-1 labeling index (LI) as a predictor of progression-free survival (PFS) among childhood PAs. Patients and Methods: Consecutive PAs were examined to determine whether the MIB-1 LI was associated with tumor progression. Other variables evaluated included tumor location, use of adjuvant therapy, extent of resection, and age at diagnosis. Results: One hundred forty-one children were identified (mean ± SD age, 7.6 ± 4.7 years; range, 0.43 to 18.56 years); 118 children had adequate tissue for MIB-1 immunohistochemistry. The 5-year PFS was 61.25%. By log-rank analysis, an MIB-1 LI of more than 2.0 was associated with shortened PFS (P = .035). Patients with PAs who underwent complete surgical resection, had tumors located in the cerebellum, and were treated with surgery only also had more prolonged PFS (P = .001 for all). Tumors in the optic pathways were associated with a shorter PFS (P = .001). Restricting the evaluation of MIB-1 LI to only incompletely resected tumors revealed an insignificant trend of MIB-1 LI of more than 2.0 having a shortened PFS. Multivariate analysis demonstrated completely resected tumors and tumors located in the cerebellum as less likely to progress (P = .001 and .019, respectively). Conclusion: Children with PAs with an MIB-1 LI of more than 2.0 have a shortened PFS. PAs that are completely resected and are located in the cerebellum have a prolonged PFS. This initial study suggests that the MIB-1 LI identifies a more aggressive subset of PAs. Further work should focus on elucidating features of pilocytic astocytomas that will identify prospectively children at risk for progression.

scholarly journals Value of Ki-67 Labeling Index in Predicting Recurrence of WHO Grade I Cranial Base Meningiomas

2018 ◽  
Vol 80 (03) ◽  
pp. 287-294 ◽  
Author(s):  
Jose Gabrielle Matias ◽  
Ignacio Jusue-Torres ◽  
Brendan Martin ◽  
Ankush Bajaj ◽  
Ewa Borys ◽  
...  
Keyword(s):  
Survival Rates ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Cranial Base ◽  
Labeling Index ◽  
Ki 67 ◽  
Who Grade ◽  
Risk Of Recurrence ◽  
Time To Recurrence ◽  
Increased Risk

Objectives Assess impact of Ki-67 labeling index (LI; Ki-67 LI) on risk of recurrence or progression of WHO grade I meningiomas. Study Design Retrospective study of adult patients who underwent resection of cranial base meningioma between 2004 and 2016. Results 272 patients fulfilled criteria for inclusion in the study. Average age was 61.8 years; 196 (72%) were females. Simpson's grade 1 resection was noted in 77 patients (32%), grade 2 in 39 (16%), grade 3 in 36 (15%), and grade 4 in 88 (37%). The Ki-67 LI was low (1–4%) in 214 (78.7%), intermediate (5–9%) in 44 (16.2%), and high (>10%) in 14 (5.2%). Median follow-up was 39 months (IQR: 16–71 months); 221 (87.1%) tumors remained stable or did not recur, 19 (7.4%) recurred, and 14 (5.5%) progressed. Compared with tumors with low Ki-67 LI, those with intermediate Ki-67 LI had 2.47 times (2.47 [1.09–5.59], p = 0.03), and those with high Ki-67 LI had 3.38 times (3.38 [1.16–9.89], p = 0.03) higher risk of recurrence or progression. Tumors with Ki-67 LI > 4% had a shorter time to recurrence or progression (p = 0.01). Recurrence or progression-free survival rates at 3, 5, and 10 years for tumors with low Ki-67 LI were 95%, 89%, and 75%, respectively; tumors with intermediate Ki-67 LI, 87%, 69%, and 52%, respectively; tumors with high Ki-67 LI, 78%, 49%, and 49%, respectively. Conclusions Following surgical resection of a WHO grade I cranial base meningioma, Ki-67 LI > 4% may predict an increased risk of recurrence or progression of residual tumor.

scholarly journals Retrospective and Randomized Analysis of Influence and Correlation of Clinical and Molecular Prognostic Factors in a Mono-Operative Series of 122 Patients with Glioblastoma Treated with STR or GTR

2020 ◽  
Vol 10 (2) ◽  
pp. 91
Author(s):  
Maurizio Salvati ◽  
Placido Bruzzaniti ◽  
Michela Relucenti ◽  
Mariagrazia Nizzola ◽  
Pietro Familiari ◽  
...  
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Primary Brain Tumor ◽  
Ki 67 ◽  
Significant Survival ◽  
Operator Series ◽  
University Of Rome

Glioblastoma is a solid, infiltrating, and the most frequent highly malignant primary brain tumor. Our aim was to find the correlation between sex, age, preoperative Karnofsky performance status (KPS), presenting with seizures, and extent of resection (EOR) with overall survival (OS), progression-free survival (PFS), and postoperative KPS, along with the prognostic value of IDH1, MGMT, ATRX, EGFR, and TP53 genes mutations and of Ki67 through the analysis of a single-operator series in order to avoid the biases of a multi-operator series, such as the lack of homogeneity in surgical and adjuvant nonsurgical treatments. A randomized retrospective analysis of 122 patients treated by a single first operator at Sapienza University of Rome was carried out. After surgery, patients followed standard Stupp protocol treatment. Exclusion criteria were: (1) patients with primary brainstem and spinal cord gliomas and (2) patients who underwent partial resections (resection < 90%) or a biopsy exclusively for diagnostic purposes. Statistical analysis with a simultaneous regression model was carried out through the use of SPSS 25® (IBM). Results showed statistically significant survival increase in four groups: (1) patients treated with gross total resection (GTR) (p < 0.030); (2) patients with mutation of IDH1 (p < 0.0161); (3) patients with methylated MGMT promoter (p < 0.005); (4) patients without EGFR amplification or EGFRvIII mutation (p < 0.035). Higher but not statistically significant survival rates were also observed in: patients <75 years, patients presenting with seizures at diagnosis, patients affected by lesions in noneloquent areas, as well as in patients with ATRX gene mutation and Ki-67 < 10%.

scholarly journals PATH-05. A CASE OF PILOCYTIC ASTROCYTOMA HARBORING THE FGFR1 GENE MUTATION WITH A PREDOMINANT OLIGODENDROGLIOMA-LIKE COMPONENT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii425-iii425
Author(s):  
Nobuyoshi Sasaki ◽  
Tomohiro Chiba ◽  
Kuniaki Saito ◽  
Keiichi Kobayashi ◽  
Yoshiaki Shiokawa ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Parietal Lobe ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Ki 67 ◽  
Who Grade ◽  
Idh1 R132h ◽  
Perifocal Edema

Abstract Pilocytic astrocytomas rarely present with oligodendroglioma-like morphological features, which gives rise to a diagnostic challenge. In this report we present a case of pilocytic astrocytoma harboring the FGFR1 mutation, accompanied with a predominant oligodendroglioma-like component, thus initially diagnosed as oligodendroglioma. A 14-year-old female presented with syncope and simple partial seizure involving her right upper limb. Contrast-enhanced MRI revealed an enhancing lesion with substantial cystic portion and perifocal edema in the left parietal lobe. Open surgery was performed and a gross total resection of the tumor was achieved. On initial histopathological diagnosis, tumor cells with monotonous round nuclei and perinuclear halo predominated with branching capillaries, which were strongly suggestive for oligodendroglioma. Immunohistochemically, IDH1 R132H was negative, and Ki-67 index was around 5%. The patient was thus initially diagnosed as oligodendroglioma, WHO grade II, based on the 2007 WHO classification criteria. However, histopathological re-review revealed a minor astrocytic component with Rosenthal fibers and rare eosinophilic granular bodies, thus the diagnosis was changed as pilocytic astrocytoma. FGFR1 K654E mutation was confirmed by Sanger sequencing. Although she postoperatively developed mild sensory disturbance in her right hands, finger agnosia, and left-right disorientation, her symptoms had gradually improved, and she was discharged on day 17 with a Karnofsky performance status (KPS) of 90 and no cognitive decline. Without any adjuvant therapies, she has remained recurrence-free for 85 months. While the diagnosis of pilocytic astrocytoma with predominant oligodendroglioma-like component can be challenging, analysis of IDH1 and FGFR1 mutations can be beneficial in certain cases.

Clinicopathological features and prognostic factors of colorectal neuroendocrine neoplasms.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 572-572
Author(s):  
Mengjie Jiang ◽  
Hanguang Hu ◽  
Ying Yuan
Keyword(s):  
Prognostic Factors ◽  
Tumor Size ◽  
Cox Regression ◽  
Survival Rates ◽  
Delayed Diagnosis ◽  
Tumor Location ◽  
Neuroendocrine Neoplasms ◽  
Clinicopathological Feature ◽  
Ki 67 ◽  
Pathological Classification

572 Background: Limited research is available regarding colorectal neuroendocrine neoplasms (NENs), especially in China. The prognostic factors of colorectal NENs remain controversial. Methods: A total of 68 patients with colorectal NENs were studied retrospectively. Clinical characteristics and prognosis between colonic and rectal NENs were compared. The Kaplan-Meier method and Cox regression models were used to evaluate the capacity of various factors to predict the outcome. Results: Of the 68 colorectal NENs patients, 43 (63.2%) had rectal NENs, and 25 (36.8%) had colonic NENs. Compared with rectal NENs, colonic NENs more frequently exhibited larger tumor size ( P < 0.0001) and distant metastasis ( P < 0.0001). Colonic NENs had a worse prognosis ( P= 0.027), with 5-year overall survival rates of 66.7% vs. 88.1% compared with rectal NENs. Neuroendocrine tumors, neuroendocrine carcinomas and mixed adenoendocrine carcinomaswere noted in 61.8%, 23.5% and 14.7% of patients, respectively. According to the available data (n = 49), Ki-67 index values were ≤ 2% in 27 (39.7%) patients, ranged from 3 to 20% in 6 patients (8.8%) and were > 20% in 16 patients (23.5%). Multivariate analyses revealed that tumor location was not an independent prognostic factor ( P= 0.081), but tumor size ( P= 0.037) and pathological classification ( P= 0.012) were independent prognostic factors. Conclusions: Significant differences in clinicopathological feature and outcome exist between colonic and rectal NENs. Multivariate analysis indicated that tumor size and pathological classification were associated with the prognosis. However, tumor location was not an independent factor. The worse outcome of colonic NENs observed in clinical practice might be due not only to the biological differences, but also to larger tumor size in colonic NENs caused by the delayed diagnosis.

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