Pretreatment hemoglobin level influences local control and survival of T1-T2 squamous cell carcinomas of the glottic larynx.

1995 ◽  
Vol 13 (8) ◽  
pp. 2077-2083 ◽  
Author(s):  
D A Fein ◽  
W R Lee ◽  
A L Hanlon ◽  
J A Ridge ◽  
C J Langer ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Local Control ◽  
Squamous Cell ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Local Control Rate ◽  
Cox Proportional Hazards ◽  
Hemoglobin Level ◽  
Cancer Center

PURPOSE A number of reports have documented the relationship between pretreatment hemoglobin level and local control and/or survival in the treatment of cervix, bladder, and advanced head and neck tumors. Consideration of correcting anemia before initiation of radiation therapy may prove increasingly important as clinical trials use intensive induction chemotherapy in the treatment of head and neck carcinomas. Neoadjuvant chemotherapy may produce anemia, which in turn may reduce the effectiveness of subsequent irradiation. MATERIALS AND METHODS One hundred nine patients with T1-2N0 squamous cell carcinoma of the glottic larynx were treated with definitive radiotherapy at the Fox Chase Cancer Center between June 1980 and November 1990. Follow-up times ranged from 26 to 165 months (median, 82). RESULTS The 2-year local control rate for patients who presented with a hemoglobin level < or = 13 g/dL was 66%, compared with 95% for patients with a hemoglobin level more than 13 g/dL (P = .0018). The 2-year survival rate for patients with a hemoglobin level < or = 13 g/dL was 46%, compared with 88% for patients with a hemoglobin level more than 13 g/dL (P < .001). Cox proportional hazards regression analysis showed that hemoglobin level (P = .0016) was the only variable that significantly influenced local control (P = .0016) and survival (P < .0001). CONCLUSION Patients who presented with hemoglobin levels more than 13 g/dL had significantly higher local control and survival rates. The strong apparent correlation between hemoglobin level, local control, and survival supports consideration of correcting anemia before initiation of radiation therapy.

scholarly journals Analysis of Radiation Therapy for the Control of Merkel Cell Carcinoma of the Head and Neck Based on 36 Cases and a Literature Review

2008 ◽  
Vol 87 (11) ◽  
pp. 634-643 ◽  
Author(s):  
Brian D. Lawenda ◽  
Michelle G. Arnold ◽  
Valerie A. Tokarz ◽  
Joshua R. Silverstein ◽  
Paul M. Busse ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Local Control ◽  
Clinical Stage ◽  
Local Control Rate ◽  
Stage I ◽  
Stage Iii ◽  
Regional Control ◽  
Kaplan Meier ◽  
Significant Difference

Merkel cell carcinoma (MCC) is a rare and aggressive epidermal cancer. We conducted a retrospective study and literature review to investigate the impact that radiation therapy has on local, regional, and distant control as part of the oncologic management of MCC of the head and neck and to further elucidate the role of radiation therapy with regard to regional control for the clinically uninvolved neck. We reviewed all registered cases of head and neck MCC that had occurred at four institutions from January 1988 through December 2005. Treatment and outcomes data were collected on patients with American Joint Committee on Cancer stage I, II, and III tumors. Local, regional, and distant control rates were calculated by comparing variables with the Fisher exact test; Kaplan-Meier analysis was used to report actuarial control data. Stage I to III head and neck MCC was identified in 36 patients— 22 men and 14 women, aged 43 to 97 years (mean: 71.6) at diagnosis. Patients with stage I and II tumors were combined into one group, and their data were compared with those of patients with stage III tumors. Twenty-sixpatients(72%) had clinical stage I/II disease and 10 patients (28%) had clinical stage III disease. Median follow-up was 41 months for the stage I/II group and 19 months for the stage III group. Based on examination at final follow-up visits, local recurrence was seen in 7 of the 36 patients (19%), for a local control rate of 81 %. The 2-year actuarial local control rate for all stages of MCC was 83%; by treatment subgroup, the rates were 95% for those who had undergone radiation therapy to the primary site and 69%) for those who had not— a statistically significant difference(p = 0.020). Based on information obtained at final follow-ups, 10 of the 36 patients (28%) experienced a regional recurrence, for a regional control rate of 72%. The 2-year actuarial regional control rate among all patients was 70%; by subgroup, rates were 82%) for patients who had undergone regional node radiation therapy and 60% for those who had not— not a statistically significant difference (p = 0.225). Nine patients (25%) overall developed a distant metastasis, for a distant control rate of 75%. Salvage therapies included chemotherapy and/or radiation therapy to the metastatic site, but neither had any significant effect on survival. Regardless of treatment, the Kaplan-Meier survival curves leveled off at 30 months with 82% survival for the stage I/II group and at 19 months with 60% survival for the stage III group. We conclude that radiation therapy to the primary tumor site (either following resection or definitively) results in a local control rate of more than 90% in patients with head and neck MCC. We also found a trend toward improved regional control of the clinically negative neck with the addition of radiation therapy.

scholarly journals High PD-L1 Expression Associates with Low T-Cadherin Expression and Poor Prognosis in HPV-Negative Head and Neck Squamous Cell Carcinoma

2021 ◽  
Author(s):  
Qiuju Wang ◽  
Yanzhen Zhao ◽  
Yan Chen ◽  
Yibo Chen ◽  
Xiaoyu Song ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
Protein Expression ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

Abstract PurposeT-cadherin is an immunoglobulin-like adhesion molecule which acts as a tumor suppressor gene, programmed cell death ligand 1 (PD-L1) is a cell surface protein that involves in the suppression of the immune system. This study aimed at exploring the correlation between T-cadherin and PD-L1, as well as their prognostic value in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC). MethodsIn this study, immunohistochemical staining was used to determine the protein expression of T-cadherin and PD-L1 in 104 tissue specimens of HPV-negative HNSCC. Spearman linear correlation analysis was used to determine the association between protein expression of T-cadherin and PD-L1. Kaplan-Meier analysis was used to plot overall survival (OS) and disease-free survival (DFS) curves. Cox proportional hazards regression analysis was used to conduct univariate and multivariate analysis. ResultsThe results showed a large negative association between protein expression of T-cadherin and PD-L1 (r=-0.775, P<0.01), expression of T-cadherin and PD-L1 were associated with OS (P=0.021 and 0.034, respectively) and DFS (P=0.012 and 0.016, respectively) in patients with HPV-negative HNSCC. Cox proportional hazards regression analysis revealed that expression of T-cadherin and PD-L1 were independent prognostic predictors for OS and DFS in patients with HPV-negative HNSCC. The worst prognosis was observed in patients with T-cadherin negative/PD-L1 positive.ConclusionIn conclusion, expression of T-cadherin and PD-L1 were inversely correlated and were independent prognostic factors for patients with HPV-negative HNSCC.

The effect of dose escalation for large squamous cell carcinomas of the anal canal: A National Cancer Database study.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 791-791
Author(s):  
Rahul Neal Prasad ◽  
Joshua Elson ◽  
Jordan Kharofa
Keyword(s):  
Anal Cancer ◽  
Local Control ◽  
Squamous Cell ◽  
Dose Escalation ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
National Cancer Database ◽  
Kaplan Meier

791 Background: Chemoradiation allows for organ preservation in patients with anal cancer, but patients with large tumors (T3/T4) continue to have high rates of locoregional recurrence. With conformal radiation techniques, there is interest in dose escalation to improve local control for large tumors. Methods: The National Cancer Database (NCDB) was used to identify patients with anal cancer from 2004-2013 with tumors > 5 cm in size. Adult patients with T3 or T4 squamous cell carcinoma who received definitive chemoradiation were included. Patients with prior resection were excluded. Higher dose was defined as > than or equal to 5940 Gy. Statistical analyses were performed using logistic regression, Kaplan-Meier, and Cox proportional hazards for overall survival (OS). Results: In total, 1349 patients were analyzed with 412 (30.5%) receiving higher dose radiation therapy (RT). Dose in the higher group ranged from 5940 – 7000 Gy. 5-year OS was 58% and 60% for higher and lower dose RT, respectively. On univariate analysis, higher dose RT (HR 0.998, CI 0.805 - 1.239, p = 0.9887) was not associated with a change in OS but older age (HR 1.484, CI 1.193 - 1.844, p = 0.0004), male sex (HR 1.660, CI 1.355 - 2.033, p < 0.0001), comorbidities (HR 1.496, CI 1.183 - 1.893, p = 0.0008), and long RT (HR 1.248, CI 1.016 - 1.533, p = 0.0347) were significantly associated with decreased OS. The results of multivariate analysis are shown in the Table. Conclusions: There was no observed difference in OS for dose escalation of anal cancers > 5 cm in this population-based analysis, but differences in local control cannot be assessed through the NCDB. Males, elderly, and comorbid patients were particularly high-risk populations with poor chemoradiation survival outcomes. Reducing treatment breaks is important for improving outcomes. Whether dose escalation of large tumors may improve local control and colostomy-free survival remains an important question and is the subject of ongoing trials. [Table: see text]

scholarly journals Stereotactic ablative radiotherapy (SABR) for recurrent and previously irradiated head and neck cancers

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190051
Author(s):  
Anil Kumar Anand ◽  
Bharat Dua ◽  
Anil Kumar Bansal ◽  
Heigrujam Malhotra Singh ◽  
Amit Verma ◽  
...  
Keyword(s):  
Head And Neck ◽  
Local Control ◽  
Proportional Hazards ◽  
Poor Response ◽  
Class Ii ◽  
Cox Proportional Hazards ◽  
Treatment Modalities ◽  
Stereotactic Ablative Radiotherapy ◽  
High Dose ◽  
Grade 3

Objective: To assess the response and toxicity of stereotactic ablative radiotherapy (SABR) in patients with recurrent head and neck cancer (HNC), who had previously received radiation for their primary tumor. Methods: Between 2014 and 2018, patients who received SABR to recurrent HNC within the previously irradiated region were retrospectively reviewed. Mean age was 60 years (range 30–78 Years). Histology was confirmed in all patients. MRI and /or CT-positron emission tomography were done to evaluate local extent and to rule out metastasis. Response was assessed as per RECIST/PERCIST Criteria. Cox proportional hazards regression and the Kaplan–Meier methods were used for statistical analysis. Results: 32 patients received SABR. RPA Class II, III patients were 20 and 12 respectively. 87% patients received a dose of ≥30 Gy/5 fractions. Median follow-up was 12 months. Estimated 1 year and 2 years local control was 64.2 and 32% and 1 year and 2 years overall survival was 67.5 and 39.5% respectively. Acute Grade 2 skin and Grade 3 mucosal toxicity was seen in 31.3 and 28% patients respectively. Late Grade 3 toxicity was seen in 9.3% patients. Conclusion: Re-irradiation with SABR yields high local control rates and is well tolerated. It compares favorably with other treatment modalities offered to patients with recurrent HNC. It is also suitable for patients of RPA Class II and III. There is need for novel systemic agents to further improve the survival. Advances in knowledge: Treatment of patients with recurrent HNC is challenging and is more difficult in previously radiated patient. More than 50% patients are unresectable. Other options of salvage treatment like re-irradiation and chemotherapy are associated with poor response rates and high incidence of acute and late toxicity (Gr ≥3 toxicity 50–70%). SABR is a novel technology to deliver high dose of radiation to recurrent tumor with high precision. It yields high local control rates with less toxicity compared to conventionally fractionated radiation.

scholarly journals Early hemoglobin status is predictive of outcomes and long-term mortality of sepsis

2020 ◽  
Author(s):  
Desheng Qi ◽  
Milin Peng
Keyword(s):  
Protective Factor ◽  
Proportional Hazards ◽  
Critical Role ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Hemoglobin Level ◽  
Survival Group ◽  
Significant Difference ◽  
One Year

Abstract Background: Hemoglobin change plays a critical role in progress of sepsis. However, the contribution of hemoglobin change to outcomes of patients with sepsis is still unknown. The aim of our study is to investigate the effect of early hemoglobin level within 48h after admission to Intensive Care Unit (ICU) on long term prognosis for sepsis. Methods: In this single centered, cohort study, we included patients from different ICU departments of Xiangya hospital from 2016 to 2018. Out of 1800 ICU patients, 199 patients with sepsis matched inclusion criteria. All 199 patients were divided into three groups according to 70, 80, and 90 g/L hemoglobin statuses, respectively. Results: Our study showed seventy-nine patients (39.7%) with ≤90g/L hemoglobin, forty-seven patients (23.6%) with hemoglobin ≤80g/L, and twenty-five (12.6%) with hemoglobin ≤70g/L at 48h after admission. Compared to survival group, there were higher rates of patients with hemoglobin ≤80g/L (33.7% vs. 15.1%, P=0.003), hemoglobin ≤70g/L (18.5% vs. 7.5%, P=0.031) in non-survival group, but similar rate of hemoglobin ≤90g/L patients (46.7% vs. 34.0%, P=0.081). Kaplan-Meier survival analysis showed that significant difference occurred among all three groups with total one-year survival rates. Furthermore, multivariate cox proportional hazards regression analysis showed that serum hemoglobin concentration ≤ 80g/L at 48h admission (Hazard Ratio HR 1.736, 95% CI 1.131-2.665, P=0.012), the occurrence of ARDS (HR 1.814, 95% CI 1.184-2.778, P=0.006), the use of CRRT (HR 1.569, 95% CI 1.030-2.390, P=0.036), and septic shock (HR 1.776, 95% CI 1.124-2.804, P=0.014) were independent risk predictors for one-year mortality in septic patients. Whereas the infection site from abdomen (HR 0.281, 95% CI 0.113-0.697, P=0.006) was the only independent protective factor for mortality in septic patients. Conclusion: ≤80 g/L hemoglobin within 48h after admission to ICU was the independent risk factor for mortality for patients with sepsis. Attention should be raised up to target early hemoglobin level in course of sepsis to achieve better outcomes of sepsis. Future larger researches and randomized controlled trials are needed to validate our results.

Clinicopathologic predictors of distant metastasis in head and neck cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6086-6086
Author(s):  
F. C. Holsinger ◽  
W. Dong ◽  
N. Bekele ◽  
R. S. Weber ◽  
M. S. Kies ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Distant Metastasis ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Primary Presentation

6086 Background: Despite advances in achieving improved locoregional control for patients with head and neck cancer (HNC), overall survival has not improved in the last 30 years. Several studies have implicated distant metastasis as a potential cause, hindering progress in the treatment of HNC. However, little is known about which patients fail systemically. We therefore sought to identify clinico-pathological factors that are associated with distant metastasis as the only cite of failure. Methods: We retrospectively studied 389 patients with head neck squamous cell carcinomas with distant metastases as the primary site of failure excluding all patients with locoregional recurrence and those receiving chemotherapy at primary presentation. The median follow up period was 5.3 years. An estimate of the risk of DM and DM free survival by prognostic factors was calculated using multivariate analysis and Cox proportional modeling. Results: Overall, 11% (43/389) of the patients developed DM. With univariate analysis, site of the tumor arising within the laryngopharynx, T stage (T3–4), N stage>2, and metastasis to level IV were significantly associated with DM. However, using Cox proportional hazards regression modeling, two clinicopathologic variables, N classification >N2b and diminishing degree of histologic differenention, were found to be most significantly associated with the development of systemic, distant metastasis. For patients staged as N2b or N2c, there was a relative risk (RR) of 6.13 (95% CI: 2.61 - 14.38; p < 0.0001) for developing DM. For patients staged as N3, the RR was 8.23 (95% CI: 2.39 - 28.38; p < 0.001). For patients with poorly differently HNSCC, RR was 11.01 (95% CI: 1.42 - 85.15; p = 0.022) Conclusions: Recognizing patients at primary presentation with tumors with the highest risk for the development of DM might le us to selectively treat them aggressively with systemic therapy to eradicate the tumor, thus improving overall survival rates. No significant financial relationships to disclose.

Predictors and prognostic importance of weight change in adult solid tumors.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 103-103 ◽  
Author(s):  
Shiva Shrotriya ◽  
Declan Walsh ◽  
Aynur Aktas ◽  
Bassam N. Estfan
Keyword(s):  
Body Weight ◽  
Prognostic Factors ◽  
Head And Neck ◽  
Solid Tumors ◽  
Weight Change ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cancer Center ◽  
Hormonal Therapies ◽  
Metastatic Sites

103 Background: Body weight change in adults with solid tumors was examined in outpatients. Objective was to determine if demographics, clinical and biochemical characteristics were associated with change in weight between visit 1 and visit 2. Examine if weight change and related parameters were associated with survival. Methods: Electronic medical records (EMR) from a tertiary cancer center retrospectively reviewed from 2009-2011. Body weight and other clinical parameters on visit 1 - within a year post diagnosis; visit 2 ≥3 weeks after visit 1. Weight change categorized as: weight gain, 0-5%, 5.01-10%, >10%. Ordinal logistic regression and Cox proportional hazards utilized for WL predictors and prognostic factors respectively. Results: N = 5,901; Mean age (±SD): 61 ± 12 years; 82% were Caucasians; 16% African Americans. Common cancers were prostate 19%; breast 15%; lung 15%; head and neck 6%; colorectal 6%; others 12%. Metastatic disease was present in 18%. Bone, brain, lymph nodes – were common metastatic sites. 45% had radiotherapy; 41% chemotherapy. Median weight change from visit 1 to visit 2 = -1 (-48, 66) kgs. Weight loss (WL) in 57% (≤5%: 30%, 5.01-10%: 13%, >10%: 14%). Different primary cancer sites, number of metastatic sites, radiotherapy/chemotherapy/hormonal therapies, older age, body mass index (BMI), and albumin predicted weight change. Median survival in 5.01-10.0% WL= 9.4 months, >10.0% = 5.3 months, and not observed ≤ 5%. Conclusions: 1. Majority lost ≤5% of body weight by visit 2. 2. Esophagus, head and neck, and pancreas (primary) - the greatest risk of WL; prostate – lowest. 3. High BMI predicted greater WL compared to normal or underweight. 4. ≤5% WL had a survival advantage compared to 5.01-10% and >10%. 5. WL remained prognostic for survival after adjusting for other prognostic factors.

Clinical behavior of stage IVC squamous cell carcinoma of the head and neck.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17511-e17511
Author(s):  
Vanessa Wookey ◽  
Adams Kusi Appiah ◽  
Avyakta Kallam ◽  
Vinicius Ernani ◽  
Lynette Smith ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Proportional Hazards ◽  
Private Insurance ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
Rank Test

e17511 Background: Squamous cell carcinoma of the head and neck (HNSCC) with distant metastasis at diagnosis (stage IVC) is rare, and outcomes are often lumped together with those of patients who relapse following initial treatment. We evaluated prognostic factors in patients presenting with stage IVC HNSCC. Methods: Data was extracted from the National Cancer Database to determine prevalence, overall survival (OS), and prognostic factors of stage IVC HNSCC (oral cavity, gum, lip, oropharynx, tongue, tonsil and hypopharynx) in adults, using SAS software for analysis. OS curves were estimated using the Kaplan-Meier method and differences were compared using a log-rank test. Significant parameters in the univariate Cox proportional hazards regression model analyses were included in the multivariate model, and hazard ratios, p-values and 95% confidence intervals were presented. Results: Of 226,302 patients with HNSCC, 5458 had distant metastases at diagnosis (2.40%); 5238 had complete data and were included in further analyses. Median survival of the entire cohort was 9.07 months, and one-year survival was 41%. Age > 70 years, Black race and higher Charlson-Deyo comorbidity score were associated with worse OS, while HPV positive status, tonsil and tongue (not including base) primary, private insurance and receipt of any treatment were associated with improved OS on univariate analysis. In multivariate analysis, HPV positive tumors were associated with improved OS compared to HPV negative tumors (HR 0.63, 95% CI 0.48-0.82; p= 0.001), even after adjusting for site of tumor origin. Only patients with a Charlson-Deyo score of ≥2 had worse OS compared to those without comorbidities. Hypopharynx, lip, tonsil and base of tongue primaries had significantly worse OS compared to gum and other mouth. Except for radiation alone and radiation with surgery, treatment demonstrated significant improvement in OS compared to no treatment, a combination of chemotherapy, radiation and surgery provided the largest survival benefit (HR 0.23, 95% CI 0.20-0.28). Conclusions: HPV positivity seems to predict for better prognosis, regardless of site of origin. Patients with metastatic HNSCC should be offered multimodality therapy in order to improve outcomes.

Squamous cell carcinoma of the head and neck treated with radiation therapy: The impact of neck stage on local control

1988 ◽  
Vol 14 (2) ◽  
pp. 249-252 ◽  
Author(s):  
William M. Mendenhall ◽  
James T. Parsons ◽  
Robert J. Amdur ◽  
Ann E. Spangler ◽  
Tim R. Williams ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Local Control ◽  
Squamous Cell ◽  
The Impact

Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors

2011 ◽  
Vol 29 (22) ◽  
pp. 3044-3049 ◽  
Author(s):  
Jonathan R. Strosberg ◽  
Asima Cheema ◽  
Jill Weber ◽  
Gang Han ◽  
Domenico Coppola ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Proportional Hazards ◽  
Tnm Classification ◽  
Survival Rates ◽  
Tnm Staging ◽  
Cox Proportional Hazards ◽  
Cancer Center ◽  
Pancreatic Neuroendocrine Tumors ◽  
American Joint Committee ◽  
Staging Classification

Purpose The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated. Methods Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications. Results We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival. Conclusion The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice.

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