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
Specialty: Hematology Oncology, Surgery, general, Endocrinology
ICD-10: ,