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Research identifies accurate indicators of recurrence for rare form of pancreatic cancer.

28 March 2012

A team of Italian researchers have identified two strong predictors of cancer recurrence in patients with a rare form of pancreatic cancer, pancreatic neuroendocrine tumours (PNETs).

PNETs represent only one to two per cent of all pancreatic tumours, and because they respond well to surgery, they have a better outlook than the most common type of pancreatic cancer, pancreatic ductal adenocarcinomas (PDA).   Currently little is known about factors that may help predict the likelihood of PNET recurrence after successful surgery.

The study published in the European Journal of Cancer looked at data held by the Surgical Department at Verona University from 57 patients who had surgery to remove PNETs between 1990 and 2008. Recurrent disease was found in 24 of the study participants.

By comparing data from all the patients, the researchers refined the use of two factors used to predict the likelihood of other cancers reoccurring for use with PNETs. These were the number of lymph nodes containing cancerous cells (lymph node ratio) and the percentage of cells that expressed a protein, called Ki67, involved in cell replication (Ki67 value).

Currently, the European Neuroendocrine Tumour Society (ENETS) recommend using a Ki67 value of two per cent as a predictive indicator of recurrence. However, the researchers found that a Ki67 value of greater than five per cent was a more accurate predictor of PNET recurrence. The researchers were also able to assign a cut-off value to the lymph node ratio, above which the likelihood of PNETs reoccurring is significantly increased.

The authors found that both a lymph node ratio greater than 0.20 and a Ki67 value of greater than 5 per cent were associated with significantly lower percentage two- and five-year disease-free survival rates.

The authors hope that the use of these predictors will help identify patients at high risk of recurrence and aid decisions about their treatment.

The research team included researchers from The University of Verona, “La Sapienza” University in Rome, The Department of Surgery at Ospedale Sacro Cuore in Verona and the ARC-NET Centre for Applied Research on Cancer in Verona.

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