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Guido Rindi Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, Rome, Italy
ENETS Center of Excellence, Neuroendocrine Tumour (NET) Center, Rome, Italy

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Frediano Inzani Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
ENETS Center of Excellence, Neuroendocrine Tumour (NET) Center, Rome, Italy

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-invasion-metastasis deposition. At the same time, prognosis depends on NEN cancer biology and displays a range of clinical behaviors from low to high grade malignancy. Indeed, a large fraction of well-differentiated NEN behave as low-grade malignant if not indolent. In fact, the

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M Lacroix Laboratoire Jean-Claude Heuson de Cancérologie Mammaire, Institut Jules Bordet, Université Libre de Bruxelles, 127 boulevard de Waterloo, B-1000 Bruxelles, Brussels, Belgium

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R-A Toillon Laboratoire Jean-Claude Heuson de Cancérologie Mammaire, Institut Jules Bordet, Université Libre de Bruxelles, 127 boulevard de Waterloo, B-1000 Bruxelles, Brussels, Belgium

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G Leclercq Laboratoire Jean-Claude Heuson de Cancérologie Mammaire, Institut Jules Bordet, Université Libre de Bruxelles, 127 boulevard de Waterloo, B-1000 Bruxelles, Brussels, Belgium

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expression or proliferation. A classification based on an ER-positive/ ER-negative or a low-grade/high-grade dichotomy hardly suffices to describe the complex spectrum of breast tumors; however, its simplicity will facilitate our main purpose: evaluating the

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Giulia Vocino Trucco Pathology Unit, SS. Annunziata Hospital, Savigliano, Italy

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Marco Volante Department of Oncology, University of Turin, Orbassano, Turin, Italy

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fundamental criteria to define either low-grade or high-grade neoplasms or G1, G2, or G3 NETs ( Table 1 ). Table 1 Well-differentiated neuroendocrine neoplasm terminology and grading systems across different tumor locations according to the 5th edition

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Marijn A Vermeulen Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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Carolien H M van Deurzen Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands

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Shusma C Doebar Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

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Wendy W J de Leng Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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John W M Martens BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands
Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

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Paul J van Diest Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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Cathy B Moelans Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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of methylated cases and absolute methylation percentages were compared between low/intermediate-grade and high-grade DCIS-AIC and between low/intermediate-grade and high-grade IBC. PAX6 and CDH13 showed higher absolute methylation percentages in

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Maria Chiara Zatelli Department of Medical Sciences, Section of Endocrinology and Internal Medicine, University of Ferrara, Ferrara, Italy

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Elia Guadagno Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy

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Erika Messina Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

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Fabio Lo Calzo Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

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Antongiulio Faggiano Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

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Annamaria Colao Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

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NIKE Group
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large-cell carcinomas, mainly concerning cytological features ( Fazio & Milione 2016 ). This morphological diagnostic algorithm, combined with Ki-67 LI evaluation, discriminates well-differentiated high-grade neoplasms (G3 NET) from neuroendocrine

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Krystallenia I Alexandraki Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Ariadni Spyroglou Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Stylianos Kykalos Second Department of Propaedeutic Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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Kosmas Daskalakis Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Georgios Kyriakopoulos Department of Pathology, Evaggelismos Hospital, Athens, Greece

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Georgios C Sotiropoulos Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Gregory A Kaltsas Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Ashley B Grossman Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
NET Unit, Royal Free Hospital, London, UK
Barts and the London School of Medicine, London, UK

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et al. 2019 ). Interestingly, in high-grade lung NENs comparative spatial/temporal analyses have confirmed that these tumours emerge from less aggressive clones which, though genetically-heterogeneous, then accumulate ‘neuroendocrine carcinoma

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Liang Zhang Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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Tobias Åkerström Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

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Kazhan Mollazadegan Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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Felix Beuschlein Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich (USZ) and Univeristät Zürich (UZH), Zurich, Switzerland
Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany

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Karel Pacak Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA

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Britt Skogseid Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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Joakim Crona Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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another metastatic neoplasm, or (iii) overall exclusion of PPGL. Fear of CNB may also lead to delay in patients under investigation for a malignancy where an incidentaloma is found. One example is patients with high-grade neoplasms such as lung cancer

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Takeshi Ujike Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Motohide Uemura Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Department of Therapeutic Urologic Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Atsunari Kawashima Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Akira Nagahara Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Kazutoshi Fujita Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Yasushi Miyagawa Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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Norio Nonomura Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

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examining 354 patients undergoing robot-assisted prostatectomy, they concluded that low FT levels were linked with high-grade prostate cancer. In total, the relationship between prostate cancer risk and absolute androgen concentration remain controversial

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Darren Cowzer Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ronak H Shah Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Joanne F Chou Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ritika Kundra Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Sippy Punn Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Laura Fiedler Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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April DeMore Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Marinela Capanu Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Michael F Berger Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Pathology and laboratory medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Diane Reidy-Lagunes Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill Medical College of Cornell University, New York, New York, USA

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Nitya Raj Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill Medical College of Cornell University, New York, New York, USA

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intermediate grade (grade 2; Ki67 3–20%) disease, and 8 (32%) had high grade (grade 3; Ki67 >20%) disease. All patients had stage IV disease at the time of plasma collection for cfDNA analysis. Table 1 Patient characteristics at the time of first cfDNA

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Massimo Milione 1st Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

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Patrick Maisonneuve Division of Epidemiology and Biostatistics, European Institute of Oncology (IEO), Milan, Italy

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Alessio Pellegrinelli 1st Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

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Federica Grillo Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova and Policlinico San Martino, Genova, Italy

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Luca Albarello Pathology Unit, IRCCS San Raffaele Scientifica Institute, Milan, Italy

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Paola Spaggiari Cancer Center Humanitas, Milan, Italy

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Alessandro Vanoli Fondazione IRCCS Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy

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Giovanna Tagliabue Lombardy Cancer Registry, Varese Province Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

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Eleonora Pisa Division of Pathology, European Institute of Oncology (IEO), Milan, Italy

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Luca Messerini Diagnostic and Molecular Pathology, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy

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Giovanni Centonze Department of Experimental Oncology and Molecular Medicine, Unit of Tumor Genomics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Clinical Research Lab (CRAB), Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

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Frediano Inzani Anatomic Pathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy

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Aldo Scarpa ARC-Net Research Centre and Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, Verona, Italy

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Mauro Papotti Department of Oncology, University of Turin, Turin, Italy

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Marco Volante Department of Oncology, University of Turin, Turin, Italy

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Fausto Sessa Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Nicola Fazio Gastrointestinal Medical Oncology and Neuroendocrine Tumors Unit, European Institute of Oncology (IEO), Milan, Italy

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Giancarlo Pruneri 1st Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
University of Milan, School of Medicine, Milan, Italy

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Guido Rindi Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore-Fondazione Policlinico Universitario A. Gemelli, Rome, Italy

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Enrico Solcia Fondazione IRCCS Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy

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Stefano La Rosa Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland

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Carlo Capella Department of Medicine and Surgery, University of Insubria, Varese, Italy

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.004 *Some immunohistochemical evaluations are missing for some patients. Budding: single tumor cell or a cell cluster (buds) of up to 4 tumor cells, detected at the invasive tumor front; Low grade budding: <4 buds; Intermediate grade budding: 5–10 buds; High-grade

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