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Neuroendocrine tumors of the colon and rectum: prognostic relevance and comparative performance of current staging systems.

https://arctichealth.org/en/permalink/ahliterature118405
Source
Ann Surg Oncol. 2013 Apr;20(4):1170-8
Publication Type
Article
Date
Apr-2013
Author
Ryaz Chagpar
Yi-Ju Chiang
Yan Xing
Janice N Cormier
Barry W Feig
Asif Rashid
George J Chang
Y Nancy You
Author Affiliation
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Source
Ann Surg Oncol. 2013 Apr;20(4):1170-8
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Aged
Colonic Neoplasms - classification - mortality - pathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
Neoplasm Metastasis
Neoplasm Staging - standards
Neuroendocrine Tumors - classification - mortality - secondary
Prognosis
Rectal Neoplasms - classification - mortality - pathology
Registries
Survival Rate
Abstract
With increasing interest in neuroendocrine tumors (NETs), three staging systems for NETs of the colon and rectum have been published. Their prognostic relevance has not been examined and compared in an independent clinical database.
From the National Cancer Database (NCDB), 5457 patients diagnosed with colorectal neuroendocrine tumor (CRNETs) between 1998 and 2002 were staged according to the staging systems from (1) European Neuroendocrine Tumor Society (ENETS, 2006; n = 1537); (2) American Joint Committee on Cancer (AJCC, 2009; n = 1140); and (3) location-specific staging systems from the Surveillance Epidemiology and End Results (SEER, 2008; n = 942). Stage-stratified overall survival (OS) and Cox-specific concordance indices were calculated for each system. Independent prognostic factors were identified by multivariate analysis.
Five-year OS for stage I, II, III, and IV CRNETs as defined by the ENETS staging system were 90.8, 77.3, 53.1, and 14.8 %, respectively. For well-differentiated CRNETs, the 5-year OS for stage I, II, III, and IV as defined by the AJCC staging system were superior: 90.6, 83.9, 64.8, and 24.9 %, respectively. Both staging systems had a concordance index of 0.72. After specifying location in the colon versus rectum, all three systems demonstrated acceptable performance. Histologic grade was a significant independent predictor of OS not currently incorporated in the staging systems.
The three staging systems showed comparable prognostic stratification of CRNETs, while the AJCC and ENETS systems are the most parsimonious. The current analysis supports the use of the AJCC for well-differentiated disease and ENETS systems for all CRNETs until there is further evidence for modification.
PubMed ID
23212760 View in PubMed
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Staging practice for prostate cancer varies and is not in line with clinical guidelines.

https://arctichealth.org/en/permalink/ahliterature280940
Source
Dan Med J. 2016 Dec;63(12)
Publication Type
Article
Date
Dec-2016
Author
Lars J Petersen
Yuliya Shuytsky
Helle D Zacho
Source
Dan Med J. 2016 Dec;63(12)
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Bone Neoplasms - diagnostic imaging - secondary
Denmark
Guideline Adherence - trends
Humans
Magnetic Resonance Imaging
Male
Neoplasm Grading
Neoplasm Staging - standards
Practice Guidelines as Topic
Prospective Studies
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood - pathology
Surveys and Questionnaires
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
Abstract
The objective was to describe regional variations in M-staging in patients with newly diagnosed prostate cancer within a Danish county and to compare clinical practice with guideline recommendations.
Data were as captured from 1) a prospective, non-interventional study counting 635 consecutive patients referred for M-staging in the 2008-2009 period at three regional hospitals within one county, and 2) a questionnaire on M-staging practice completed by the five sites performing M-staging in the same county in 2015.
All three sites referred patients for M-staging in 2008, irrespective of their risk factors. Two of the three sites maintained this practice in 2015. Furthermore, in 2015, three of five sites performed M-staging in intermediate and high-risk patients only. Planar whole-body bone scans were standard in all sites in 2008 with single photon emission computed tomography/computed tomography (SPECT/CT) being performed if required and if available. In 2015, two sites used choline positron emission tomography/CT for primary staging of high-risk patients against guideline recommendations. The use of SPECT/CT showed wide variations from "if required" to "mandatory" head-to-thigh imaging. There were notable variations between clinical practice and guidelines in 2008, and this was even more evident in 2015.
Considerable variations existed with respect to the M-staging imaging practices in prostate cancer within a single Danish county. The variation was more pronounced in 2015 than in 2008. Clinical practice conflicted in part with European and national Danish guidelines.
none.
not relevant.
PubMed ID
27910797 View in PubMed
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