Patients with gastroenteropancreatic neuroendocrine tumors
Keywords:
Gastroenteropancreatic neuroendocrine tumor, response to treatment, overall survivalAbstract
Background : Gastroenteropancreatic neuroendocrine tumors (NET-GEP) are very low incidence diseases, although they represent 70 % of all neuroendocrine tumors, and 2 % of all gastrointestinal tumors.
Objetives : To characterize clinical evolution, response to treatment, and overall survival in patients with NET-GEP.
Method : Longitudinal and retrospective study, with 88 patients diagnosed with NET-GEP, who were diagnosed, treated, and followed at the "Hermanos Ameijeiras" Hospital between January 2008 and December 2014.
Results : The median age was 57 years (31;84), with predominance of female patients, ages between 50-69 years, normal nutritional status, ECOG 1-2, and symptomatic at diagnosis. Patients with a primary pancreatic site, well-differentiated carcinomas, G1, mixed histological pattern, and clinical stage IV predominated. 70 % of patients received surgery at diagnosis, and pancreatic and small bowel or colon resections account for 72 % of this. The variables with the worst rate of disease control and survival (OS) are: male sex, malnutrition, ECOG 3-4, neuroendocrine carcinoma, clinical stage IV, and no surgery at diagnosis (p <0.05). The histological grade G3 was statistically significant for SV, but not for the control of the disease. The OS rates obtained at 1.3, and 5 years are 71.1 %, 51.5 %, and 45.8 %, respectively, while the median OS was 66 months (54.24; 77.70).
Conclusions : This work is the first observational study on NET-GEP in Cuba, which includes results of the treatments in the so-called "real world" and the data provided will serve as a benchmark for comparison in the incorporation of new diagnostic and treatment technologies.
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References
Massironi S, Sciola V, Peracchi M, Ciafardini C, Spampatti MP. Neuroendocrine tumors of the gastro-enteropancreatic system. World J Gastroenterol. 2008;14:537784.
Modlin IM, Oberg K, Chung DC. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61-72.
Berardi R, Rinaldi S, Torniai M. Gastrointestinal neuroendocrine tumors: searching the optimal treatment strategy--A literature review. Crit Rev Oncol Hematol. 2016;98:264-74. PubMed:PMID:26643525.
Fraenkel M, Kim M, Faggiano A, de Herder WW, Valk GD. Incidence of gastroenteropancreatic neuroendocrine tumours: a systematic review of the literature. Endocr Relat Cancer. 2014;21:R153-63. PudMed:PMID:24322304.
Öberg KE. Gastrointestinal neuroendocrine tumors. Ann Oncol. 2010;Suppl 7:vii 72-80.
Soriano JL, Lima M, Batista N. Tumores Neuro-Endocrinos. En: Manual de Prácticas Médicas IV Edición. Unidad Funcional de Tumores. Tomo 2. La Habana: Editorial Ciencias Médicas; 2012. p.595-631.
Dasari A, Shen C, Halperin D. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017;3:1335-42. PubMed:PMID:28448665.
Lewkowicz E, Trofimiuk-Müldner M, Wysocka K. Gastroenteropancreatic neuroendocrine neoplasms: a 10-year experience of a single center. Pol Arch Med Wewn. 2015;125: 337-46. PubMed:PMID:25924181.
Sánchez García NL, González Fabián L, Hano García OM, García Bacallao EF, Infante Velásquez M, Jiménez Galainena JJ, et al. Tumores neuroendocrinos del tracto gastroenteropancreático. Estudio multicéntrico. Rev Haban Cienc Méd [Internet]. 2017 [citado 12 Abr 2018];16:937-45. Disponible en: http://scielo.sld.cu/pdf/rhcm/v16n6/rhcm10617.pdf .
Alsina M, Marcos Gragera R, Capdevila J, Buxó M, Ortiz RM, Barretina P, et al. Neuroendocrine tumors: a population-based study of incidence and survival in Girona Province, 1994-2004. Cancer Epidemiol. 2011;35:49-54.
Tsai HJ, Wu CC, Tsai CR, Lin SF, Chen LT,Chang JS The epidemiology of neuroendocrine tumors in Taiwan: a nation-wide cancer registry-based study. PLoS One. 2013;8:e62487.
Niederle MB, Hackl M, Kaserer K, Niederle B. Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. Endocr Relat Cancer. 2010;17: 909-18.
Teixeira FJR, Couto Netto SDD, Akaishi EH. Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature. World J Emerg Surg. 2017;12:12. PubMed:PMID:28286544.
Garcia Carbonero R, Capdevila J, Crespo Herrero G. Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): results from the National Cancer Registry of Spain (RGETNE). Ann Oncol. 2010;21:1794-803.
Büyükaşık K, Arı A, Tatar C,Akçe B,Sevinç MM, Sarı S. Clinicopathological features of gastroenteropancreatic neuroendocrine tumors: A retrospective evaluation of 42 cases. Turk J Surg. 2017;33:279-83. PubMed:PMID:29260133.
Yao JC, Hassan M, Phan A. One hundred years after ''carcinoid'': epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008; 26:3063-72.
Hauso O, Gustafsson BI, Kidd M. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer. 2008;113:2655-64.
Helland SK, Prøsch AM, Viste A. Carcinoid tumours in the gastrointestinal tract - a population-based study from Western Norway. Scand J Surg. 2006;95:158-61.
O'Connor JM, Marmissolle F, Bestani C,Pesce V, Belli S, Dominichini E , et al. Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study. Mol Clin Oncol. 2014; 2: 673-684. PubMed:PMID:25054030.
Ito T, Igarashi H, Nakamura K, Sasano H, Okusaka T, Takano K, et al. Epidemiological trends of pancreatic and gastrointestinal neuroendocrine tumors in Japan: a nationwide survey analysis. J Gastroenterol. 2015;50:58-64. PubMed:PMID:24499825.
Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. In: WHO series on histological and genetic typing of human tumours. 4th ed. 2010.
Velayoudom Cephise FL, Duvillard P, Foucan L,Hadoux J, Chougnet CN, Leboulleux S , et al. Are G3 ENETS neuroendocrine neoplasms heterogeneous? Endocr Relat Cancer. 2013;20:649-57. PubMed:PMID:23845449.
Basturk O, Yang Z, Tang LH, Hruban RH, Adsay V, McCall CM, et al. The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms. Am J Surg Pathol. 2015;39:683-90. PubMed:PMID:25723112.
Coriat R, Walter T, Terris B, Couvelard A, Ruszniewski P. Gastroenteropancreatic well-differentiated grade 3 neuroendocrine yumors: review and position statement. Oncologist. 2016;21:1191-9. PubMed:PMID:27401895.
Garcia Carbonero R, Sorbye H, Baudin E, Raymond E , Wiedenmann B, Niederle B, et al. ENETS Consensus Guidelines for high-grade gastroenteropancreatic neuroendocrine tumors and neuroendocrine carcinomas. Neuroendocrinology, 2016;103:186-94. PubMed:PMID:26731334.
Wang YH, Lin Y, Xue L, Wang JH, Chen MH, Chen J. Relationship between clinical characteristics and survival of gastroenteropancreatic neuroendocrine neoplasms: A single-institution analysis (1995-2012) in South China. BMC Endocr Disord. 2012;12:30-2.
Lepage C, Bouvier AM, Faivre J. Endocrine tumours- epidemiology of malignant digestive neuroendocrine tumours. Eur J Endocrinol. 2013;168:77-83.
Zhang X, Ma L, Bao H, Zhang J, Wang Z, Gong P. Clinical, pathological and prognostic characteristics of gastroenteropancreatic neuroendocrine neoplasms in China: a retrospective study. BMC Endocr Disord. 2014;14:54. PubMed:PMID:25001493.
Shu XL, Kang K, Gu LJ, Zhang YS. Effect of early enteral nutrition on patients with digestive tract surgery: A meta-analysis of randomized controlled trials. Exp Ther Med. 2016;12:2136-44. PubMed:PMID:27698702.
Yanar H, Sivrikoz E, Yanar F. Local surgical treatment of gastroenteropancreatic neuroendocrine tumors. Turkiye Klinikleri J Med Oncol-Special Topics. 2013;6:28-33.
Partelli S, Maurizi A, Tamburrino D, Baldoni A, Polenta V, Crippa S, et al. GEP-NETS update: surgery of neuroendocrine tumors. Eur J Endocrinol. 2014;171:R153-62.
Yamaguchi T, Machida N, Morizane C, Kasuga A, Takahashi H, Sudo K, et al. Multicenter retrospective analysis of systemic chemotherapy for advanced neuroendocrine carcinoma of the digestive system. Cancer Sci. 2014;105:1176-81. PubMed:PMID:24975505.
Sørbye H, Strosberg J, Baudin E, Klimstra DS, Yao JC. Gastroenteropancreatic highgrade neuroendocrine carcinoma. Cancer. 2014;120:2814-23. PubMed.PMID:24771552.
Modlin IM, Frilling A, Salem RR, Alaimo D, Drymousis P, Wasan H, et al. Blood measurement of neuroendocrine gene transcripts defines the effectiveness of operative resection and ablation strategies. Surgery. 2016;159:336-47. PubMed.PMID:26456125.
Garcia Carbonero R, Garcia Figueiras R, Carmona Bayonas A, Sevilla I, Teule A, Quindos M, et al. Imaging approaches to assess the therapeutic response of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): current perspectives and future trends of an exciting field in development. Cancer Metastasis Rev. 2015;34:823-42.
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