Ferrone et al evaluated prognostic factors in patients with a pancreatic endocrine tumors. These can help identify patients who may benefit from more aggressive management. The authors are from Memorial Sloan-Kettering Cancer Center.
Outcome: 5 year disease-specific survival (DSS)
Parameters:
(1) histologic grade
(2) diameter in cm
(3) presence or absence of nodal or distant metastases
Histologic grade:
(1) no necrosis AND 0-1 mitoses in 50 high power fields (40x objective) = benign (low grade)
(2) necrosis OR >= 2 mitoses in 50 high power fields = intermediate
Histologic Grade
Distant Metastases
Diameter
Percent 5 Year Disease Specific Survival (DSS)
low
present
NA
93%
low
absent
>= 2 cm
87%
low
absent
< 2 cm
100%
intermediate
present
NA
58%
intermediate
absent
>= 2 cm
72%
intermediate
absent
< 2 cm
100%
where:
• In the WHO classification metastases indicate a malignant tumor.
• The differential diagnosis of metastasis (especially for a low grade histology) is a multifocal tumor.
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