预测转移性一级胃肠胰神经内分泌肿瘤预后的因素

IF 1.6 Q4 ONCOLOGY
Journal of Gastrointestinal Cancer Pub Date : 2024-09-01 Epub Date: 2024-06-14 DOI:10.1007/s12029-024-01077-9
Saneya A Pandrowala, Deeksha Kapoor, Aditya Kunte, Amit Chopde, Ameya Puranik, Indraja Devidas Dev, Rahul Parghane, Sandip Basu, Anant Ramaswamy, Vikas Ostwal, Vikram A Chaudhari, Manish S Bhandare, Shailesh V Shrikhande
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引用次数: 0

摘要

简介胃肠胰神经内分泌肿瘤(GEP-NET)的发病率稳步上升。这些肿瘤即使发生转移,也被认为是相对不活跃的。在这种情况下,决定生存结果的因素尚未得到充分研究:回顾性分析前瞻性维护的NET诊所数据库,纳入2018年1月至2021年12月的转移性1级GEP-NET患者,评估影响无进展生存期(PFS)的因素:在研究期间接受治疗的589例GEP-NET患者中,100例为1级,有放射学证据表明存在远处转移。中位年龄为 50 岁,67% 为男性。其中,15 名患者接受了观察,85 名患者接受了手术(32 人)、肽受体放射性核素治疗(50 人)、奥曲肽 LAR(22 人)和/或化疗(4 人)等治疗,治疗方式可以是单一方式,也可以是多方式治疗。中位(PFS)为 54.5 个月。估计的3年PFS和3年总生存率分别为72.3%(SE 0.048)和93.4%(SE 0.026)。在 Cox 回归中,肝脏肿瘤负荷高是预测 PFS 的唯一独立指标(OR 3.443,P = 0.014)。合并肝外疾病患者的5年OS明显低于肝局限性疾病患者(70.7% vs. 100%,p = 0.017):结论:肝脏疾病负担越重,转移性I级GEP-NET患者的PFS越短。结论:肝脏疾病负担越重,转移性 I 级 GEP-NET 患者的 PFS 越短,伴有肝外受累的患者的 OS 明显越低。这些参数可能证明,对转移性1级GEP-NET应采取更积极的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Predicting Prognosis in Metastatic Grade 1 Gastro-entero-pancreatic Neuroendocrine Tumors.

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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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
121
期刊介绍: The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology:  This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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