Hochwald et al classified pancreatic endocrine neoplasms into low and intermediate grades based on histologic features. The authors are from the University of Florida in Gainesville and Memorial Sloan-Kettering Cancer Center.
Patient selection:
(1) peripancreatic endocrine neoplasms
(2) Patients with high-grade neuroendocrine carcinomas were excluded (widespread necrosis and mitotic rate > 10 mitoses per 10 high power microscopic fields).
(3) Patients were evaluated if they underwent curative resection. This would probably exclude a person with multiple metastases. Metastases to liver or lymph nodes was significant for predicting disease free survival in nonfunctioning neoplasms, but was not for functioning (hormone producing) neoplasms.
Parameters:
(1) mitotic activity
(2) presence of tumor necrosis
Parameter
Finding
Points
mitotic rate
0 to 1 mitoses in 50 high power fields (hpf)
0
>= 2 mitoses in 50 hpf
1
tumor necrosis
absent
0
present
1
total score =
= SUM(points for the 2 parameters)
Interpretation:
• minimum score: 0
• maximum score: 2
Score
Tumor Grade
10 Year Disease Specific Survival
15 Year Disease Specific Survival
0
low grade
80%
80%
1 or 2
intermediate grade
44%
22%
approximated from Figure 4, page 2638
To read more or access our algorithms and calculators, please log in or register.
