Sarah B Bateni, Natalie G Coburn, Calvin Law, Simron Singh, Sten Myrehaug, Angela Assal, Julie Hallet
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引用次数: 0
摘要
神经内分泌肿瘤(NET)诊断后,第二原发癌(SPCs)的风险增加。SPCs在该人群中的临床意义尚不清楚。本研究的目的是评估NET诊断后SPCs与生存之间的关系。我们使用监测、流行病学和最终结果数据库,对2000年至2016年的NET患者(胃肠道、胰腺或肺部原发性)进行了一项基于人群的回顾性队列研究。Cox回归模型评估了SPCs与net特异性(NET-SS)、癌症特异性(CSS)和总生存期(OS)之间的关系。在58,553例NET患者中,7.9%经历了SPC。SPCs与较差的OS(风险比(HR) 2.14, 95% CI 1.94-2.36)和CSS (HR 2.31, 95% CI 2.06-2.59)相关,NET-SS无差异(HR 1.04, 95% CI 0.87-1.23)。组织学分级的分层分析显示,良好分化和中度分化的NETs结果相似,但低分化NETs的OS和CSS无差异(P > 0.05)。在NET位点的分层分析中,SPCs与胃肠道NET的不良OS (HR 3.41, 95% CI 3.01-3.87)和CSS (HR 4.96, 95% CI 4.28-5.74)相关,与肺部NET的不良OS (HR 1.25, 95% CI 1.03-1.52)相关,而CSS (HR 1.08, 95% CI 0.85-1.36)无差异。SPCs与胰腺NETs的OS或CSS差异无相关性(P > 0.05)。综上所述,与不进行SPC相比,net后的SPC与较差的OS和CSS相关,但与NET-SS无关。这些数据突出表明,需要在网络中进行长期随访,包括发现特殊细胞,以确保早期诊断和及时管理。
Second primary cancers and survival among neuroendocrine tumor patients.
There is an increased risk of second primary cancers (SPCs) after neuroendocrine tumor (NET) diagnosis. The clinical significance of SPCs in this population is unknown. The purpose of this study was to evaluate the association between SPCs after NET diagnosis and survival. We performed a population-based, retrospective cohort study of NET patients (gastrointestinal, pancreatic, or lung primary) from 2000 to 2016 using the Surveillance, Epidemiology, and End Results database. Cox regression models assessed the association between SPCs and NET-specific (NET-SS), cancer-specific (CSS), and overall survival (OS). Of 58,553 NET patients, 7.9% experienced an SPC. SPCs were associated with worse OS (hazard ratio (HR) 2.14, 95% CI 1.94-2.36) and CSS (HR 2.31, 95% CI 2.06-2.59) with no difference in NET-SS (HR 1.04, 95% CI 0.87-1.23). Stratified analyses by histologic grade showed similar results for well and moderately differentiated NETs, but no difference in OS or CSS for poorly differentiated NETs (P > 0.05). In stratified analyses by NET site, SPCs were associated with worse OS (HR 3.41, 95% CI 3.01-3.87) and CSS (HR 4.96, 95% CI 4.28-5.74) in gastrointestinal NETs and worse OS (HR 1.25, 95% CI 1.03-1.52) with no difference in CSS (HR 1.08, 95% CI 0.85-1.36) in lung NETs. SPCs were not associated with a difference in OS or CSS in pancreatic NETs (P > 0.05). In conclusion, SPCs after NETs were associated with inferior OS and CSS compared to no SPC but were not associated with NET-SS. These data highlight the need for long-term follow-up in NETs to include the detection of SPCs to ensure early diagnosis and timely management.
期刊介绍:
Endocrine-Related Cancer is an official flagship journal of the Society for Endocrinology and is endorsed by the European Society of Endocrinology, the United Kingdom and Ireland Neuroendocrine Society, and the Japanese Hormones and Cancer Society.
Endocrine-Related Cancer provides a unique international forum for the publication of high quality original articles describing novel, cutting edge basic laboratory, translational and clinical investigations of human health and disease focusing on endocrine neoplasias and hormone-dependent cancers; and for the publication of authoritative review articles in these topics.
Endocrine neoplasias include adrenal cortex, breast, multiple endocrine neoplasia, neuroendocrine tumours, ovary, prostate, paraganglioma, parathyroid, pheochromocytoma pituitary, testes, thyroid and hormone-dependent cancers. Neoplasias affecting metabolism and energy production such as bladder, bone, kidney, lung, and head and neck, are also considered.