Factors Predicting Prognosis in Metastatic Grade 1 Gastro-entero-pancreatic Neuroendocrine Tumors

被引:0
作者
Pandrowala, Saneya A. [1 ]
Kapoor, Deeksha [1 ]
Kunte, Aditya [1 ]
Chopde, Amit [1 ]
Puranik, Ameya [2 ]
Dev, Indraja Devidas [2 ]
Parghane, Rahul [3 ]
Basu, Sandip [3 ]
Ramaswamy, Anant [4 ]
Ostwal, Vikas [4 ]
Chaudhari, Vikram A. [1 ]
Bhandare, Manish S. [1 ]
Shrikhande, Shailesh V. [1 ]
机构
[1] Tata Mem Hosp, Homi Bhabha Natl Inst, Dept Surg Oncol, Gastrointestinal & Hepatopancreato Biliary Serv, Mumbai 400012, Maharashtra, India
[2] Homi Bhabha Natl Inst, Tata Mem Ctr, Dept Nucl Med & Mol Imaging, Mumbai 400012, Maharashtra, India
[3] Tata Mem Hosp Annexe, Bhabha Atom Res Ctr, Radiat Med Ctr, Mumbai 400012, Maharashtra, India
[4] Homi Bhabha Natl Inst, Tata Mem Ctr, Dept Med Oncol, Mumbai 400012, Maharashtra, India
关键词
Neuroendocrine tumor; Grade; 1; Metastases; Progression-free survival; Overall survival; ENETS CONSENSUS GUIDELINES; LIVER-TRANSPLANTATION; HEPATIC METASTASES; OCTREOTIDE LAR; MANAGEMENT; MIDGUT; EPIDEMIOLOGY; NEOPLASMS;
D O I
10.1007/s12029-024-01077-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction The incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NET) has steadily increased. These tumors are considered relatively indolent even when metastatic. What determines survival outcomes in such situations is understudied.Materials and Methods Retrospective analysis of a prospectively maintained NET clinic database, to include patients of metastatic grade 1 GEP-NET, from January 2018 to December 2021, to assess factors affecting progression-free survival (PFS).Results Of the 589 patients of GEP-NET treated during the study period, 100 were grade 1, with radiological evidence of distant metastasis. The median age was 50 years, with 67% being men. Of these, 15 patients were observed, while 85 patients received treatment in the form of surgery (n = 32), peptide receptor radionuclide therapy (n = 50), octreotide LAR (n = 22), and/or chemotherapy (n = 4), either as a single modality or multi-modality treatment. The median (PFS) was 54.5 months. The estimated 3-year PFS and 3-year overall survival rates were 72.3% (SE 0.048) and 93.4% (SE 0.026), respectively. On Cox regression, a high liver tumor burden was the only independent predictor of PFS (OR 3.443, p = 0.014). The 5-year OS of patients with concomitant extra-hepatic disease was significantly lower than that of patients with liver-limited disease (70.7% vs. 100%, p = 0.017).Conclusion A higher burden of liver disease is associated with shorter PFS in patients with metastatic grade I GEP-NETs. The OS is significantly lower in patients with associated extrahepatic involvement. These parameters may justify a more aggressive treatment approach in metastatic grade 1 GEP-NETs.
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页码:1220 / 1228
页数:9
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