Evaluation of Clinical Prognostic Factors and Further Delineation of the Effect of Mesenteric Fibrosis on Survival in Advanced Midgut Neuroendocrine Tumours

Neuroendocrinology
Faidon-Marios LaskaratosChristos Toumpanakis

Abstract

Small intestinal neuroendocrine tumours (SI NETs) represent 30-50% of small bowel neoplasms and often present at an advanced stage. To date, there is relatively limited literature regarding prognostic factors affecting overall survival (OS) in stage IV disease. In addition, the prevalence of mesenteric fibrosis (MF) in SI NETs and its effect on OS have not been sufficiently explored in the literature. The primary aim of this study was to perform a large-scale survival analysis in an institutional cohort of 387 patients with metastatic (stage IV) SI NETs. The secondary aim was to provide epidemiological information regarding the prevalence of MF and to evaluate its effect on OS. The median OS was 101 months (95% CI 84, 118). Age > 65 years, mesenteric metastases with and without desmoplasia, liver metastases, carcinoid heart disease (CHD) and bone metastases were associated with a significantly shorter OS, while primary tumour resection was predictive of a longer OS. The benefit of surgical resection was limited to symptomatic patients. MF was present in approximately 50% of patients with mesenteric lymphadenopathy. Elevated urinary 5-HIAA levels correlated strongly with the presence of CHD (p < 0.001) and to a lesser extent (p ...Continue Reading

Citations

Jan 24, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Diamantis I TsilimigrasTimothy M Pawlik
Sep 27, 2019·Endocrine Reviews·Johannes HoflandWouter W de Herder
Oct 16, 2019·Journal of Surgical Oncology·Yosuke KasaiEric K Nakakura
Aug 2, 2020·World Journal of Surgery·Julie HalletUNKNOWN Commonwealth Neuroendocrine Tumours Research Collaborative (CommNETs) Surgical Section
Aug 17, 2020·World Journal of Surgery·Julie HalletUNKNOWN Commonwealth Neuroendocrine Tumours Research Collaborative (CommNETs) Surgical Section
May 13, 2020·Annals of Surgical Oncology·Alexandra GangiRichard Tuli
Jan 22, 2021·Journal of Neuroendocrinology·Eleonora PelleJonathan Strosberg
Oct 20, 2019·Best Practice & Research. Clinical Endocrinology & Metabolism·Frank Weber, Henning Dralle
Apr 3, 2021·World Journal of Gastrointestinal Surgery·Cornelius J FernandezJoseph M Pappachan

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