TY - JOUR
T1 - Advanced digestive neuroendocrine tumors
T2 - Metastatic pattern is an independent factor affecting clinical outcome
AU - Panzuto, Francesco
AU - Merola, Elettra
AU - Rinzivillo, Maria
AU - Partelli, Stefano
AU - Campana, Davide
AU - Iannicelli, Elsa
AU - Pilozzi, Emanuela
AU - Mercantini, Paolo
AU - Rossi, Michele
AU - Capurso, Gabriele
AU - Scarpa, Aldo
AU - Cascinu, Stefano
AU - Tomassetti, Paola
AU - Falconi, Massimo
AU - Fave, Gianfranco Delle
PY - 2014/3
Y1 - 2014/3
N2 - OBJECTIVES: The objective of this study was to determine the impact of different metastatic spread patterns on outcome in advanced digestive neuroendocrine tumors (NETs). METHODS: This was a retrospective analysis of patients with stage IV NETs, classified as group 1 (unilobar liver metastases), group 2 (bilobar liver metastases), group 3 (extra-abdominal metastases). End points were overall survival (OS) and progression-free survival (PFS). Risk factor analysis was performed using Cox proportional hazard model. RESULTS: Of the 229 patients, 135 (58.9%) had pancreatic, and 94 (41.1%) small bowel NETs: 32 (13.9%) were included in group 1, 179 (78.2%) in group 2, and 18 (7.9%) in group 3. Median Ki67 was 4.5%. Overall, 5-year OS was 55%. Different OS was observed among the 3 groups: median survival not reached, 81 and 8 months, respectively (P <0.001). Median PFS was 18 months. Both OS and PFS were significantly affected by Ki67 and metastatic spread pattern. CONCLUSIONS: The stratification of stage IV NET patients based on metastatic patterns, alongside Ki67, predicts the clinical outcome. The extent of metastatic disease is a previously unrecognized variable, which should be considered when evaluating the results of treatments in NET patients with advanced disease.
AB - OBJECTIVES: The objective of this study was to determine the impact of different metastatic spread patterns on outcome in advanced digestive neuroendocrine tumors (NETs). METHODS: This was a retrospective analysis of patients with stage IV NETs, classified as group 1 (unilobar liver metastases), group 2 (bilobar liver metastases), group 3 (extra-abdominal metastases). End points were overall survival (OS) and progression-free survival (PFS). Risk factor analysis was performed using Cox proportional hazard model. RESULTS: Of the 229 patients, 135 (58.9%) had pancreatic, and 94 (41.1%) small bowel NETs: 32 (13.9%) were included in group 1, 179 (78.2%) in group 2, and 18 (7.9%) in group 3. Median Ki67 was 4.5%. Overall, 5-year OS was 55%. Different OS was observed among the 3 groups: median survival not reached, 81 and 8 months, respectively (P <0.001). Median PFS was 18 months. Both OS and PFS were significantly affected by Ki67 and metastatic spread pattern. CONCLUSIONS: The stratification of stage IV NET patients based on metastatic patterns, alongside Ki67, predicts the clinical outcome. The extent of metastatic disease is a previously unrecognized variable, which should be considered when evaluating the results of treatments in NET patients with advanced disease.
KW - carcinoids
KW - metastases
KW - neuroendocrine tumors
KW - pancreatic endocrine tumors
KW - staging
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U2 - 10.1097/MPA.0000000000000032
DO - 10.1097/MPA.0000000000000032
M3 - Article
C2 - 24518498
AN - SCOPUS:84894436231
VL - 43
SP - 212
EP - 218
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 2
ER -