{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:31:31Z","timestamp":1784863891228,"version":"3.55.0"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2013,10,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Small intestinal (SI) neuroendocrine tumors (NETs) have heterogeneous outcomes. The NET societies have recently proposed a TNM staging classification. In this study, we used population-based data to assess the validity of the staging system. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We identified patients with SI-NETS diagnosed between 1988 and 2009 from the Surveillance, Epidemiology, and End Results registry. We used Kaplan-Meier analysis to assess disease-specific survival according to TNM status. Cox models were constructed to evaluate differences in prognosis after controlling for potential confounders. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> We identified 6,792 patients with SI-NET. Although the current staging system was predictive of prognosis, there was overlap among some groups (stage I\/IIA, P = .36; stage IIB\/IIIB, P = .70). Additionally, stage IIIB patients had better survival than stage IIIA patients (P &lt; .001). Adjusted analyses showed similar outcomes for T1 versus T2 disease (hazard ratio [HR], 1.02; 95% CI, 0.63 to 1.66). Patients with T3 (HR, 3.60; 95% CI, 2.28 to 5.69) and T4 (HR, 5.50; 95% CI, 3.42 to 8.86) tumors had significantly worse survival than patients with T1 disease. N1 involvement conferred worse survival in T1 (HR, 3.08; 95% CI, 1.75 to 5.44) and T2 disease (HR, 2.73; 95% CI, 1.84 to 4.07) but not in T3 (HR, 0.99; 95% CI, 0.76 to 1.30) or T4 (HR, 0.98; 95% CI, 0.71 to 1.35) disease. A revised classification showed no overlap in survival across groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Progressively more advanced T status is associated with worse SI-NET prognosis. Regional lymph node involvement is a marker of worse survival only among patients with T1 or T2 status. These results suggest that revisions to the current staging classification may be helpful. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2013.51.1477","type":"journal-article","created":{"date-parts":[[2013,9,17]],"date-time":"2013-09-17T04:34:59Z","timestamp":1379392499000},"page":"3776-3781","source":"Crossref","is-referenced-by-count":54,"title":["Revised Staging Classification Improves Outcome Prediction for Small Intestinal Neuroendocrine Tumors"],"prefix":"10.1200","volume":"31","author":[{"given":"Michelle Kang","family":"Kim","sequence":"first","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.P.","family":"Warner","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasan","family":"Roayaie","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noam","family":"Harpaz","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen C.","family":"Ward","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Itzkowitz","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Wisnivesky","sequence":"additional","affiliation":[{"name":"All authors: Mount Sinai School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2010.12.005"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/25.4.722"},{"key":"B3","first-page":"699","volume":"89","author":"DiSario JA","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4377"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/BF00199342"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-59655-1"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-007-0452-1"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-006-0250-1"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ebb2a5"},{"key":"B10","volume-title":"TNM Classification of Malignant Tumours","author":"Sobin LH","year":"2009"},{"key":"B11","volume-title":"AJCC Cancer Staging Manual","author":"Edge SB","year":"2010"},{"key":"B12","volume-title":"WHO Classification of Tumours of the Digestive System","author":"Bosman F","year":"2010"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25855"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs208"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.1817"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824e6108"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23549"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6051"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-0734"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2008.06.005"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.5924"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.07.042"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2013.51.1477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T22:53:08Z","timestamp":1653519188000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2013.51.1477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,20]]},"references-count":22,"journal-issue":{"issue":"30","published-print":{"date-parts":[[2013,10,20]]}},"alternative-id":["10.1200\/JCO.2013.51.1477"],"URL":"https:\/\/doi.org\/10.1200\/jco.2013.51.1477","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,20]]}}}