{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:27:57Z","timestamp":1793701677187,"version":"4.5.1"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the clinicopathological features of composite gangliocytoma\/neuroma and neuroendocrine tumour (CoGNET) and possible risk factors for nodal metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      We compiled a cohort of 71 cases from 19 institutions. Mean patient age was 58\u2009years. Thirty\u2010eight (54%) patients were male. Most patients (65%) had symptoms, including abdominal pain (20%) and gastrointestinal bleeding (19%). Most cases (70%) were described as a subepithelial mass\/nodule, and nearly half (45%) were located in the 2nd portion of the duodenum. Mean tumour size was 2.2\u2009cm, and most (87%) were well\u2010circumscribed. Nearly all cases (96%) demonstrated all three histologic components, with the epithelioid component being the most predominant overall (mean 59%). All cases involved the submucosa, with 7 (10%) additionally involving the muscularis propria. Solid areas of ganglion\u2010like cells were identified in 16\/69 (23%) cases, glandular structure formation in 15\/70 (21%), lymphovascular invasion (LVI) in 6\/70 (9%) cases, and perineural invasion and necrosis in one case each. Nodal metastasis was identified at diagnosis in 8 (11%) cases; increased age, increased size, LVI and muscularis propria involvement were all significantly associated with nodal disease (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Follow\u2010up data were available for 68 patients (mean 47\u2009months); nearly all were alive without disease, though one patient developed liver metastasis after 8\u2009months and died of the disease after 63\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This largest series of CoGNET to date demonstrates that approximately 10% of cases develop nodal metastases. Large tumour size, muscularis propria involvement, advanced patient age and LVI appear to be risk factors for nodal metastasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/his.15535","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T11:06:37Z","timestamp":1754996797000},"page":"933-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Composite gangliocytoma\/neuroma and neuroendocrine tumour: a contemporary analysis of 71 cases shows risk factors for metastasis"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-7895","authenticated-orcid":false,"given":"Luiz M","family":"Nova\u2010Camacho","sequence":"first","affiliation":[{"name":"Department of Pathology Donostia University Hospital  San Sebastian Spain"},{"name":"Department of Pathology, Immunology, and Laboratory Medicine University of Florida  Gainesville FL 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