Prognostic factors and survival in endocrine tumor patients: Comparison between gastrointestinal and pancreatic localization

Francesco Panzuto, Silvia Nasoni, Massimo Falconi, Vito Domenico Corleto, Gabriele Capurso, Sara Cassetta, Michela Di Fonzo, Valentina Tornatore, Massimo Milione, Stefano Angeletti, Maria Sofia Cattaruzza, Vincenzo Ziparo, Cesare Bordi, Paolo Pederzoli, Gianfranco Delle Fave

Research output: Contribution to journalArticle

Abstract

Since gastro-entero-pancreatic endocrine tumors are rare and heterogeneous diseases, their prognosis and long-term survival are not well known. This study aimed at identifying prognostic factors and assessing long-term survival in gastro-entero-pancreatic endocrine tumors. A total of 156 patients enrolled. Prognostic factors were determined by univariate/multivariate analysis; survival rates were assessed by the Kaplan-Meier method. The tumors were non-functioning in 59.6% of patients, and originated from the pancreas in 42.9%. At diagnosis, 64.3% of patients had metastases. The tumors were well differentiated in 89.6% of patients. Ki67 was > 2% in 39.6% of patients. Primary tumor size was > 3 cm in 49.6% of cases studied. For the univariate analysis, the negative prognostic factors were: pancreatic origin (rate ratio 4.64, P = 0.0002), poorly differentiated tumor (rate ratio 7.70, P = 0.0001), primary tumor size > 3 cm (rate ratio 4.26, P = 0.0009), presence of distant metastases (liver: rate ratio 5.88, P = 0.01; distant extra-hepatic: rate ratio 13.41, P = 0.0008). The pancreatic site, the poor degree of differentiation and the distant metastases were confirmed as negative prognostic factors at multivariate analysis. Overall 5-year survival rate was 77.5%. Survival rates differed according to: primary tumor site (62% for pancreatic vs 89.9% for gastrointestinal tract, P = 0.0001) and size (65.7% for > 3 cm vs 88.8% for ≤ 3 cm, P= 0.0003), degree of differentiation (22% for poor vs 86.8% for good, P <0.0001), Ki67 (53.5% for > 2% vs 90.1% for ≤ 2%, P = 0.003), metastases (96.1, 77, 73.3 and 50.1% for absent, local, liver and distant extra-hepatic metastases respectively), age at diagnosis (85.3% for ≤ 50 years vs 70.3% for > 50 years, P = 0.03). Although 64.3% of gastro-entero-pancreatic endocrine tumors present metastases at diagnosis, the 5-year survival rate is 77.5%. Pancreatic site, a poor degree of tumor cell differentiation and distant extra-hepatic metastases are the major negative prognostic factors.

Original languageEnglish
Pages (from-to)1083-1092
Number of pages10
JournalEndocrine-Related Cancer
Volume12
Issue number4
DOIs
Publication statusPublished - Dec 2005

ASJC Scopus subject areas

  • Endocrinology
  • Oncology
  • Cancer Research
  • Endocrinology, Diabetes and Metabolism

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    Panzuto, F., Nasoni, S., Falconi, M., Corleto, V. D., Capurso, G., Cassetta, S., Di Fonzo, M., Tornatore, V., Milione, M., Angeletti, S., Cattaruzza, M. S., Ziparo, V., Bordi, C., Pederzoli, P., & Delle Fave, G. (2005). Prognostic factors and survival in endocrine tumor patients: Comparison between gastrointestinal and pancreatic localization. Endocrine-Related Cancer, 12(4), 1083-1092. https://doi.org/10.1677/erc.1.01017