Τίτλος:
The prognosis and management of neuroendocrine neoplasms-related metastatic bone disease: lessons from clinical practice
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: To study the evolution and optimal management of metastatic bone disease (mBD) in patients with neuroendocrine neoplasms (NENs). Methods: Seventy-four patients were recruited from four NEN centers in this observational multicenter study. Results: Pancreas and small bowel were the most common primaries (30 and 27%, respectively). Almost all gastrointestinal (GI)-NENs were grades 1 and 2, whereas bronchopulmonary-thymic were atypical carcinoids. Thirty-two (43%) patients had synchronous metastatic bone disease (mBD) and three patients reported bone-specific symptoms; metachronous mBD developed at a median of 35 (range: 4–395) months. Thirty-six (86%) of patients with metachronous mBD had stage IV disease at diagnosis. Somatostatin receptor functional imaging and computed tomography were the modalities mostly used for mBD identification. Fifty-two patients received assessable bone-related therapy (bisphosphonates, denosumab, local radiotherapy, and radionuclide treatment). Improvement in mBD was seen in 5, stable disease in 22, and deterioration in 25 patients. The presence of synchronous mBD and the negative outcome of bone-related therapy negatively affected overall survival (OS). In the multivariate analysis, the stronger predictor of OS was the outcome of bone-related therapy (HR: 4.753; 95% CI: 1.589–14.213). Bisphosphonates therapy was the mostly used bone-specific treatment but its monthly administration did not affect OS. At last follow-up, 39 patients were alive with OS 50 (14–463) months. Conclusions: Early investigation for mBD offers a prognostic marker of patients with NENs, since synchronous mBD has a negative impact on survival. The outcome of bone-related therapy affects OS but the monthly administration of bisphosphonates did not show a benefit over less intense schemes. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Alexandraki, K.I.
Pizanias, M.
Uri, I.
Thomas, D.
Page, T.
Kolomodi, D.
Low, C.S.
Adesanya, O.
Tsoli, M.
Gross, D.J.
Randeva, H.
Srirajaskanthan, R.
Grozinsky-Glasberg, S.
Kaltsas, G.
Weickert, M.O.
Περιοδικό:
Endocrine Development
Εκδότης:
Humana Press Inc.
Λέξεις-κλειδιά:
bevacizumab; bisphosphonic acid derivative; denosumab; gadolinium; interferon; pentetreotide; radioisotope, adult; aged; Article; bone metastasis; bronchus carcinoid; cancer grading; cancer mortality; cancer prognosis; cancer radiotherapy; cancer staging; cancer survival; cancer therapy; external beam radiotherapy; female; follow up; human; intestine cancer; major clinical study; male; multicenter study; neuroendocrine carcinoma; nuclear magnetic resonance imaging; observational study; onset age; overall survival; pancreas metastasis; priority journal; retrospective study; single photon emission computed tomography; very elderly; x-ray computed tomography; bone tumor; diagnostic imaging; disease management; intestine tumor; middle aged; neuroendocrine tumor; pancreas tumor; pathology; prognosis; young adult, Adult; Aged; Aged, 80 and over; Bone Neoplasms; Diphosphonates; Disease Management; Female; Humans; Intestinal Neoplasms; Male; Middle Aged; Neuroendocrine Tumors; Pancreatic Neoplasms; Prognosis; Tomography, X-Ray Computed; Young Adult
DOI:
10.1007/s12020-019-01838-8
