The use of MR evaluated by FDG-PET in the assessment of treatment efficacy in MPM appears promising. Our observations need to be validated in a larger prospective series.
Neuroendocrine tumours displaying somatostatin receptors have been successfully visualised with somatostatin receptor imaging (SRI). However, there may be differences in sensitivity depending on the site of the primary tumour and/or its metastases. We studied 131 patients affected by neuroendocrine tumours of the gastro-entero-pancreatic (GEP) tract. A pathological diagnosis was obtained in 116 patients, while in 15 the diagnosis was based on instrumental results and follow-up. Fifty-one patients were examined for staging purposes, 80 were in follow-up. Images were acquired 24 and 48 h after the injection of 150-220 MBq of indium-111 pentetreotide. Whole-body and SPET images were obtained in all patients. Patients were also studied with computed tomography (CT), ultrasound (US), and other procedures. Tumours were classified according to their site of origin: pancreas n = 39, ileum n = 32, stomach n = 16, appendix n = 9, duodenum n = 5, jejunum n = 5, rectum n = 3, biliary tract n = 2, colon n = 2, caecum n = 1, liver metastases from unknown primary = 15, widespread metastases from unknown primary = 2. Sensitivity for primary tumour localisation was as follows: SRI = 62%; CT = 43%; US = 36%; other procedures = 45%. Sensitivity for liver metastases: SRI = 90%; CT = 78%; US = 88%; other procedures = 71%. Sensitivity for the detection of extrahepatic soft tissue lesions was: SRI = 90%; CT = 66%; US = 47%; other procedures = 61%. Sensitivity for the detection of the primary tumour in patients with metastases from unknown primary sites: SRI 4/17; CT 0/13; US 0/12; other procedures 1/10. In 28% of the patients SRI revealed previously unknown lesions, and in 21% it determined a modification of the scheduled therapy. Our study confirms the important role of SRI in the management of GEP tumours. However, we feel that a critical investigation should address its role in locating primary tumours, in particular in patients with metastases from unknown primary sites.
Editor-in-Chief: A. Giustina ▶ Covers leading topics in endocrinology ▶ Includes Hormones of reproduction, metabolism, growth, and ion balance ▶ Offers the latest on insulin and diabetes ▶ Presents newly-emerging endocrine-related topics ▶ 94% of authors who answered a survey reported that they would definitely publish or probably publish in the journal againWell-established as a major journal in today's rapidly advancing experimental and clinical research, Endocrine publishes full-length original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical (including proof of concept studies and clinical trials) research in all the different fields of endocrinology and metabolism. Endocrine covers the following leading topics in Endocrinology such as: Neuroendocrinology, Pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, type 1 and type 2 diabetes, hormones of male and female reproduction, and of HPA axis, pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
Summary
This retrospective study evaluated whether early 2‐[fluorine‐18]fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) after two cycles of salvage chemotherapy (PET2) could predict survival after high‐dose chemotherapy (HDC). Twenty‐four Hodgkin lymphoma (HL) patients were included. PET2 was negative in 58% and positive in 42% of patients. Ninety per cent of patients (9/10) with positive PET2 relapsed after HDC while all but one patient with negative PET2 maintained a complete remission. The 2‐year progression‐free survival was 93% vs. 10% for patients with negative and positive PET2, respectively (P < 0.001). This study shows that interim PET can predict the outcome after high‐dose chemotherapy in HL patients.
The incidence of papillary thyroid cancer (PTC) is rapidly growing, the recorded increase being mainly related to tumors %2 cm. The re-classification of tumors O1 and %2 cm limited to the thyroid from the T2 to the T1 category triggered some concerns about their best management. In order to identify possible predictors of disease outcome, several clinico-pathological features were analyzed by uni-and multivariate analyses in a retrospective consecutive series of 251 PTCs %2 cm. Moreover, since 37% of cases were submitted to prophylactic central compartment node dissection (CLND, VI-VII levels) and radioiodine ablation was performed only when the tumor had an extrathyroidal extension, the impact of these therapeutic tools on the final outcome was evaluated. Among all outcome predictors analyzed, only lymph node metastases and extracapsular invasion were strongly associated with persistence/recurrence. It is worth noting that neither age nor tumor size was a significant indicator of the outcome. Interestingly, as far as the therapeutic interventions are concerned, CLND was strongly associated with remission, whereas radioiodine ablation did not influence the outcome. In conclusion, present results confirm the prognostic influence of node metastases and extra-thyroidal invasion, indicating the need for aggressive treatment in tumors extending beyond the capsule. On the contrary, all pT1N0 tumors, regardless of the diameter, the number of intrathyroidal foci, and the age can be effectively treated only by surgery. The major impact of prophylactic CLND on prognosis suggests to routinely associate it to total thyroidectomy in cases with a preoperative diagnosis of malignancy.
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