Cedars-Sinai researchers, along with collaborators from multiple institutions, have developed and validated a new tool designed to predict the risk of recurrence in patients with pancreatic neuroendocrine tumors (PanNETs). The findings were published in JAMA Surgery.
The research focuses on patients whose cancer has not spread to their lymph nodes and who have undergone surgical removal of their tumors. According to Cristina R. Ferrone, MD, chair of the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai and corresponding author of the study, "We now have a way to identify patients whose higher risk of recurrence may have been previously overlooked. This gives us the opportunity to change the way we care for this patient population in a meaningful way."
Pancreatic neuroendocrine tumors are less common and generally less aggressive than other forms of pancreatic cancer. Data from the American Cancer Society indicate that these patients typically experience a 91% five-year relative survival rate after surgery if their cancer has not spread beyond the pancreas or into lymph nodes. However, the Cedars-Sinai study identified that about 10% of such patients still face a significant risk that their cancer will return.
Researchers analyzed information from 770 patients treated at five high-volume medical centers. They found that recurrences most often occurred in the liver among those without lymph node involvement. Based on this analysis, they developed a 13-point risk score using four main factors: male sex, tumor size equal to or greater than three centimeters, World Health Organization grade two or higher, and evidence of lymphovascular invasion—where cancer cells are present in blood or lymph vessels.
This new scoring system allows clinicians to classify patients as low-, moderate-, or high-risk for recurrence and tailor follow-up care accordingly. Ferrone noted, "The current guidelines leave clinicians with a 'one-size-fits-all' approach, but it's clear from our research that not all patients require the same intensity of surveillance. The results address a critical gap in current practice and will hopefully influence future guideline development for well-managed, individualized and cost-effective care."
Shlomo Melmed, MB, ChB, dean of the Medical Faculty and executive vice president of Medicine and Health Sciences at Cedars-Sinai—who was not involved in the study—commented on its potential impact: "The exciting research outcomes of Dr. Ferrone and team will have a significant impact on enhancing the care and management of all patients with neuroendocrine tumors," Melmed said.
