ASO Author Reflections: Pancreatic Neuroendocrine Tumor Recurrence and Survival Predicted by Ki67

Excerpt

Risk classification of pancreatic neuroendocrine tumors is infrequently used for treatment or follow-up strategies. Multiple reasons for this lack of use can be identified. First, risk classifications are based on small retrospective data or large nationwide cohorts, with either low statistical power or high risk of bias. Second, patients are not always referred to centers of excellence, where treatment options are possibly better weighed and risk classifications known and incorporated in decisions regarding diagnostics or treatment. Referral to centers of excellence increases volume in these centers, further improving patient outcomes.1 A final third reason for the lack of use of risk classifications is the indolent behavior of pancreatic neuroendocrine tumors. Ten-year survival rates over 75%, as well as low recurrence rates, do not facilitate prospective trials on diagnostic or treatment strategies. However, if increasing data are suggestive of certain risk factors associated with tumor recurrence, collaborating centers must evaluate again and again if prospective studies are to be initiated. …