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Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor Prognosis.

Publication ,  Journal Article
Fata, CR; Gonzalez, RS; Liu, E; Cates, JM; Shi, C
Published in: Am J Surg Pathol
January 2017

Mesenteric tumor deposits (MTDs) are not included in the American Joint Committee on Cancer (AJCC) staging system for midgut small intestinal neuroendocrine tumors (NETs). We examined the prognostic significance of MTDs associated with midgut NETs. Hematoxylin and eosin slides from 132 resected jejunal/ileal NETs were reviewed for AJCC tumor stage, lymph node (LN) metastasis, MTDs, and hepatic metastases. MTDs were defined as discrete irregular mesenteric tumor nodules discontinuous from the primary tumor. Clinical or pathologic evidence of metastases and survival data were abstracted from electronic medical records. The cohort included 72 male and 60 female patients with a median age of 60 years. LN metastasis, MTDs, and liver metastasis were present in 80%, 68%, and 58% of patients, respectively. Female sex and presence of MTDs were independent predictors of liver metastasis. The odds ratio for hepatic metastasis in the presence of MTDs was 16.68 (95% confidence interval [CI], 4.66-59.73) and 0.81 (95% CI, 0.20-3.26) for LN metastasis. Age, MTDs, and hepatic metastasis were associated with disease-specific survival (DSS) in univariate analysis. Primary tumor histologic grade, pT3/T4 stage, and LN metastasis were not associated with DSS. Multivariate analysis of liver metastasis-free survival stratified by tumor grade showed that MTDs were associated with adverse outcomes. The hazard ratio for MTDs was 4.58 (95% CI, 1.89-11.11), compared with 0.98 (95% CI, 0.47-2.05) for LN metastasis. MTDs, but not LN metastasis, in midgut NETs are a strong predictor for hepatic metastasis and are associated with poor DSS.

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Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

January 2017

Volume

41

Issue

1

Start / End Page

128 / 133

Location

United States

Related Subject Headings

  • Young Adult
  • Proportional Hazards Models
  • Prognosis
  • Pathology
  • Neuroendocrine Tumors
  • Middle Aged
  • Mesentery
  • Male
  • Lymphatic Metastasis
  • Liver Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
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Fata, C. R., Gonzalez, R. S., Liu, E., Cates, J. M., & Shi, C. (2017). Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor Prognosis. Am J Surg Pathol, 41(1), 128–133. https://doi.org/10.1097/PAS.0000000000000751
Fata, Cynthia R., Raul S. Gonzalez, Eric Liu, Justin M. Cates, and Chanjuan Shi. “Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor Prognosis.Am J Surg Pathol 41, no. 1 (January 2017): 128–33. https://doi.org/10.1097/PAS.0000000000000751.
Fata, Cynthia R., et al. “Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor Prognosis.Am J Surg Pathol, vol. 41, no. 1, Jan. 2017, pp. 128–33. Pubmed, doi:10.1097/PAS.0000000000000751.

Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

January 2017

Volume

41

Issue

1

Start / End Page

128 / 133

Location

United States

Related Subject Headings

  • Young Adult
  • Proportional Hazards Models
  • Prognosis
  • Pathology
  • Neuroendocrine Tumors
  • Middle Aged
  • Mesentery
  • Male
  • Lymphatic Metastasis
  • Liver Neoplasms