[Neuroendocrine tumors of the gastroenteropancreatic system--reevaluation using the Capella classification]

Zentralbl Chir. 2003 Aug;128(8):656-62. doi: 10.1055/s-2003-41377.
[Article in German]

Abstract

Introduction: Neuroendocrine tumors of the gastroenteropancreatic system (GEP) are heterogeneous regarding hormone production, localisation and biological behaviour making the prognostic evaluation of these rare tumors difficult. Capella et al. proposed a new classification that combines for the first time both biological and prognostic characteristics. This study aimed to evaluate the prognostic value of Capella's classification in the patients treated at our hospital.

Methods: 86 from 1975-1999 surgically treated and histologically confirmed neuroendocrine tumors were retrospectively classified as benign (B), uncertain behavior (UB), low grade malignant (LG) or high grade malignant (HG) following the Capella classification. These data were correlated with the long-term outcome of the patients 8.5 (range: 1-24) years after surgery.

Results: 43 % of tumors were localised in the pancreas, the others were equally distributed in the remaining GEP. Most tumors were classified as B (42 %) or LG (41 %), few were UB (10 %) or HG (7 %). 61 patients survived free of disease, 25 patients died, 13 of them not tumor related. Tumor related deaths were only observed in 6 patients with inoperable LG- and 6 patients with HG-neuroendocrine tumors within 3 years after surgery.

Conclusion: The Capella classification reliably reflects the heterogeneity and the biological behaviour of GEP-neuroendocrine tumors and can therefore be recommended for clinical use.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Appendectomy
  • Child
  • Child, Preschool
  • Colectomy
  • Data Interpretation, Statistical
  • Digestive System / pathology
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Gastrectomy
  • Gastrointestinal Neoplasms / classification*
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Immunohistochemistry
  • Infant
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / classification*
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery
  • Pancreas / pathology
  • Pancreatectomy
  • Pancreatic Neoplasms / classification*
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Time Factors
  • Treatment Outcome