Modified Histopathological Grading Optimizes Prediction of Survival Outcomes in Small Intestinal Neuroendocrine Tumors
Authors' conclusion
Ki67 proliferation index was a strong and independent predictor of OS and EFS. A modified histopathological grading system applying Ki67 cutoffs of 5% and 10% could be superior to predict differences in SI-NET patient survival outcomes.
Study context
- Population
- Patients with well-differentiated small intestinal NETs (SI-NETs) diagnosed 1993–2021 at 5 European referral centers; median age 62.3 years, 45.7% female; 44.8% stage IV at baseline
- Participants
- 551 patients
- Exposure
- Modified Ki67 grading groups as predictors of overall survival (OS) and event-free survival (EFS)
- Outcome
- OS and EFS
- Follow-up
- Mean (±SD) 51.5 (±52.9) months
Methodological detailsmulticenter, 5 European referral centers
- Multicenter
- 5 European referral centers
Main finding
As reported in the abstract
OS (death), multivariable Cox regression
Hazard ratio (95% CI)P value
Ki67 5%-10%
2.2(1.15–4.31)
P = 0.018Ki67 ≥ 10%
5.11(2.87–9.09)
P < 0.001- Median OS
- 214.7 (95% CI, 152.7-276.6) months
Observational data: associations, not effects.
Further findings
EFS (recurrence, progression and/or death), multivariable analysis
| HR (CI) | P value | ||
|---|---|---|---|
| Ki67 ≥ 10% | 4.01 (2.6–6.37) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
- EFS (recurrence, progression and/or death), multivariable analysis — Median EFS
- 79.8 (68.2-91.5) months
EFS (recurrence, progression and/or death), multivariable analysis
- Age also independent predictor: HR 1.04 (1.02-1.05), P < .001
Original publication
Modified Histopathological Grading Optimizes Prediction of Survival Outcomes in Small Intestinal Neuroendocrine Tumors. J Clin Endocrinol Metab. Published 28 February 2024. doi:10.
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