# NORDIC NEC: predictive and prognostic factors in 305 patients with advanced gastrointestinal neuroendocrine carcinoma

Source: https://onco.cc/key-papers/paper-nordic-nec-sorbye-ann-oncol-2013/  
OnCo record `paper-nordic-nec-sorbye-ann-oncol-2013` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

This large Nordic series showed that gastrointestinal neuroendocrine carcinomas with a Ki-67 below 55 percent respond poorly to platinum-etoposide yet live longer than those above it, which led to the separation of grade 3 neuroendocrine tumours from carcinomas.

## Summary

Retrospective analysis of 305 patients with advanced gastrointestinal high-grade (grade 3) neuroendocrine carcinoma treated at Nordic centres, examining response to first-line platinum-based chemotherapy and survival by clinical and pathological features.

Response to platinum chemotherapy was 42 percent for Ki-67 of 55 percent or more but 15 percent below it, while survival was longer in the lower Ki-67 group (median 14 versus 10 months); performance status, primary site and lactate dehydrogenase were also prognostic.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Annals of Oncology
- Year: 2013
- DOI: 10.1093/annonc/mds276
- Authors: Sorbye H, Welin S, Langer SW, et al.
- Findings: Response to platinum chemotherapy 42 percent with Ki-67 of 55 percent or more vs 15 percent below.; Median survival 14 months with Ki-67 under 55 percent vs 10 months above.
- What it means: The 55 percent Ki-67 threshold and the recognition that well-differentiated grade 3 tumours behave differently from carcinomas, now embedded in the WHO classification, came from this analysis.
- Caveats: Retrospective; morphology (well versus poorly differentiated) was not systematically recorded.

## Sources

- Ann Oncol 2013: https://doi.org/10.1093/annonc/mds276
- PubMed: https://pubmed.ncbi.nlm.nih.gov/22967994/

## Connected records

- cancers: [Extrapulmonary neuroendocrine carcinoma](https://onco.cc/cancers/extrapulmonary-nec/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)

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