Insulinoma staging: Difference between revisions

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Revision as of 15:03, 15 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Staging had been done according to American Joint Cancer Committee(AJCC) 7th edition 2010. ^[1]^[2] ^[1]^[2] ^[1]

Staging

The staging of malignant insulinoma being a pancreatic neuroendocrine tumor may be classified into several subtypes based on American Joint Cancer Committee(AJCC) 7th edition 2010 ^[1]^[2] :

Stage	T	N	M
IA	T1	N0	M0
IB	T2	N0	M0
IIA	T3	N0	M0
IIB	T1-3	N1	M0
III	T4	Any N	M0
IV	Any T	Any N	M1

**AJCC 2010**
T	T1	<2 cm in greatest dimension
	T2	>2 cm in greatest dimension
	T3	Beyond the pancreas but without involvement of the superior mesenteric artery
	T4	Involvement of the celiac axis or superior mesenteric artery(unresectable tumor)
N	N0	No regional lymph node metastasis
N	N1	Regional lymph node metastasis
M	M0	No distant metastasis
M	M1	Distant metastasis

Being a pancreatic neuroendocrine tumor, it is also staged by European Neuroendocrine Tumor Society (ENETS)as ^[1]^[2]:

Stage	T	N	M
I	T1	N0	M0
IIA	T2	N0	M0
IIB	T3	N0	M0
IIIA	T4	N0	M0
III B	Any T	N1	M0
IV	Any T	Any N	M1

**ENETS**
T	T1	Tumor limited to pancreas,<2 cm
	T2	Tumor limited to pancreas,2-4 cm
	T3	>4cm, or invading the duodenum or common bile duct
	T4	Tumor invades adjacent structures
N	N0	No regional lymph node metastasis
N	N1	Regional lymph node metastasis
M	M0	No distant metastasis
M	M1	Distant metastasis

In its new 8th edition of AJCC which is planned to be published on January 1, 2018; AJCC^[1] had developed a modified ENETS (mENETS) staging classification:

Stage	T	N	M
IA	T1	N0	M0
IB	T2	N0	M0
IIA	T3	N0	M0
IIB	T1-3	N1	M0
III	T4	Any N	M0
IV	Any T	Any N	M1

**mENETS**
T	T1	Tumor limited to pancreas,<2 cm
	T2	Tumor limited to pancreas,2-4 cm
	T3	>4cm, or invading the duodenum or common bile duct
	T4	Tumor invades adjacent structures
N	N0	No regional lymph node metastasis
N	N1	Regional lymph node metastasis
M	M0	No distant metastasis
M	M1	Distant metastasis

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 Luo G, Javed A, Strosberg JR, Jin K, Zhang Y, Liu C; et al. (2017). "Modified Staging Classification for Pancreatic Neuroendocrine Tumors on the Basis of the American Joint Committee on Cancer and European Neuroendocrine Tumor Society Systems". J Clin Oncol. 35 (3): 274–280. doi:10.1200/JCO.2016.67.8193. PMID 27646952.
↑ ^2.0 ^2.1 ^2.2 ^2.3 Yang M, Zeng L, Zhang Y, Wang WG, Wang L, Ke NW; et al. (2015). "TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution". Medicine (Baltimore). 94 (12): e660. doi:10.1097/MD.0000000000000660. PMC 4554009. PMID 25816036.

Template:WikiDoc Sources

[pmid27646952-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 Luo G, Javed A, Strosberg JR, Jin K, Zhang Y, Liu C; et al. (2017). "Modified Staging Classification for Pancreatic Neuroendocrine Tumors on the Basis of the American Joint Committee on Cancer and European Neuroendocrine Tumor Society Systems". J Clin Oncol. 35 (3): 274–280. doi:10.1200/JCO.2016.67.8193. PMID 27646952.

[pmid25816036-2] 2.0 ^2.1 ^2.2 ^2.3 Yang M, Zeng L, Zhang Y, Wang WG, Wang L, Ke NW; et al. (2015). "TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution". Medicine (Baltimore). 94 (12): e660. doi:10.1097/MD.0000000000000660. PMC 4554009. PMID 25816036.

[1]

[2]

@@ Line 3: / Line 3: @@
 {{CMG}}{{AE}}{{PSD}}
 ==Overview==
-According to The American Joint Committee on Cancer (AJCC), there are four stages of insulinoma based on the TNM staging sysytem.<ref name=stage>Stage Information for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors). http://www.cancer.gov/types/pancreatic/hp/pnet-treatment-pdq#section/_199</ref>
+Staging had been done according to American Joint Cancer Committee(AJCC) 7th edition 2010. <ref name="pmid27646952" /><ref name="pmid25816036" /> <ref name="pmid27646952" /><ref name="pmid25816036" /> <ref name="pmid27646952" />
 ==Staging==
 * The staging of malignant insulinoma being a [[pancreatic neuroendocrine tumor]] may be classified into several subtypes based on American Joint Cancer Committee(AJCC) 7th edition 2010 <ref name="pmid27646952">{{cite journal| author=Luo G, Javed A, Strosberg JR, Jin K, Zhang Y, Liu C et al.| title=Modified Staging Classification for Pancreatic Neuroendocrine Tumors on the Basis of the American Joint Committee on Cancer and European Neuroendocrine Tumor Society Systems. | journal=J Clin Oncol | year= 2017 | volume= 35 | issue= 3 | pages= 274-280 | pmid=27646952 | doi=10.1200/JCO.2016.67.8193 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27646952  }} </ref><ref name="pmid25816036">{{cite journal| author=Yang M, Zeng L, Zhang Y, Wang WG, Wang L, Ke NW et al.| title=TNM staging of pancreatic neuroendocrine tumors: an observational analysis and comparison by both AJCC and ENETS systems from 1 single institution. | journal=Medicine (Baltimore) | year= 2015 | volume= 94 | issue= 12 | pages= e660 | pmid=25816036 | doi=10.1097/MD.0000000000000660 | pmc=4554009 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25816036  }} </ref> :
@@ Line 141: / Line 141: @@
 |-
 |}
-*WHO 2010 classification system combined differentiation and grading characteristics to classify the belligerence of a pancreatic neuroendocrine tumor. The aggressiveness of tumor was expressed in form of mitotic count and staining of a nuclear antigen called Ki-67<ref>{{cite book | last = Bosman | first = F. T. | title = WHO classification of tumours of the digestive system | publisher = International Agency for Research on Cancer | location = Lyon | year = 2010 | isbn = 978-9283224327 }}</ref><ref name="pmid28357177">{{cite journal |vauthors=Sun J |title=Pancreatic neuroendocrine tumors |journal=Intractable Rare Dis Res |volume=6 |issue=1 |pages=21–28 |year=2017 |pmid=28357177 |pmc=5359348 |doi=10.5582/irdr.2017.01007 |url=}}</ref>:
+*
-{| class="wikitable" style="text-align:center"
-|'''Grade of tumor'''
-|'''Mitotic Count'''(Mitoses per 10 high powerfields)
-|'''Expression of Ki 67'''
-|-
-|Grade 1
-|<2
-|≤3%
-|-
-|Grade 2
-|2-10
-|3-20%
-|-
-|Grade 3
-|>20
-|>20%
-|-
-|}
-*Grade 1 and 2 tumors were classified as neuroendocrine neoplasm (NET) and grade 3 were classified as neuroendocrine carcinoma(NEC).
 * In its new 8th edition of AJCC which is planned to be published on January 1, 2018; AJCC<ref name="pmid27646952">{{cite journal| author=Luo G, Javed A, Strosberg JR, Jin K, Zhang Y, Liu C et al.| title=Modified Staging Classification for Pancreatic Neuroendocrine Tumors on the Basis of the American Joint Committee on Cancer and European Neuroendocrine Tumor Society Systems. | journal=J Clin Oncol | year= 2017 | volume= 35 | issue= 3 | pages= 274-280 | pmid=27646952 | doi=10.1200/JCO.2016.67.8193 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27646952  }} </ref> had developed a modified ENETS (mENETS) staging classification:

Insulinoma staging: Difference between revisions

Revision as of 15:03, 15 September 2017

Overview

Staging

References

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