Τίτλος:
Recurrence and metastatic potential in Type 1 gastric neuroendocrine neoplasms
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: The aim of our study was to assess clinico-pathological and biochemical parameters of Type 1 Gastric Neuroendocrine Neoplasms (GNEN1) with respect to tumours propensity for recurrence and metastasis. Methods: Hospital charts of GNEN1 patients were reviewed at a single tertiary referral centre. Results: We included 114 consecutive patients (74 women; age at baseline 54.5 ± 12.7 years [mean ± SD]) with GNEN1. All tumours (n = 114) were well differentiated; Grade 1 (G1) accounted for 56 patients (49%), whereas 46 (40%) were Grade 2 (G2) and 12 (11%) of unknown Grade. Overall follow-up encompassed 45.3 ± 46 (mean ± SD) months in 84 patients who were subjected to annual surveillance; 44 (52%) developed recurrence in the stomach during follow-up with 22 experiencing multiple recurrences; three (2.6%) presented with metastases in locoregional lymph nodes (n = 3) and/or the liver (n = 2); No metastasis or death was reported during follow-up. Median recurrence-free survival (RFS) was 31 months (95% CI: 7.6-54.4). Among clinico-pathological and biochemical parameters investigated, endoscopic intervention compared with surgery (P-value =.009) and higher serum-gastrin levels (s-gastrin) at baseline and first-year follow-up were associated with recurrence (P-value =.022 and.003 respectively) and also shorter RFS (log-rank P =.009 for type of intervention and.014 for s-gastrin, respectively). Receiver Operator Curve analysis of s-gastrin levels at first-year follow-up for recurrence demonstrated an area under the curve of 0.702. Conclusion: Despite the relatively high prevalence of G2 tumours, endoscopically and/or surgically treated GNEN1 remains an indolent disease with a low metastatic propensity and no disease-specific mortality reported in our series. Many patients though will experience local recurrence, warranting long-term endoscopic surveillance with s-gastrin biomarker being a complementary tool in recurrence prediction. © 2019 John Wiley & Sons Ltd
Συγγραφείς:
Daskalakis, K.
Tsoli, M.
Karapanagioti, A.
Chrysochoou, M.
Thomas, D.
Sougioultzis, S.
Karoumpalis, I.
Kaltsas, G.A.
Alexandraki, K.I.
Περιοδικό:
Clinical Endocrinology
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
gastrin; gastrin, adult; area under the curve; Article; cancer grading; cancer patient; cancer surgery; cancer survival; endoscopic mucosal resection; endoscopic submucosal dissection; female; follow up; gastrectomy; hormone blood level; human; liver metastasis; lymph node metastasis; major clinical study; male; metastasis potential; middle aged; neuroendocrine tumor; priority journal; receiver operating characteristic; recurrence free survival; retrospective study; stomach antrum resection; stomach tumor; survival rate; survival time; total stomach resection; tumor recurrence; type 1 gastric neuroendocrine neoplasm; wedge resection; aged; blood; complication; disease free survival; mortality; neuroendocrine tumor; pathology; stomach tumor; tumor recurrence, Adult; Aged; Disease-Free Survival; Female; Gastrins; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neuroendocrine Tumors; ROC Curve; Stomach Neoplasms
