Impact of Mesenteric Mass in Patients With Midgut Neuroendocrine Tumors

Malik, Preeti; Pinto, C.; Naparst, Monica; Ward, Stephen; Aronson, Anne; Aalberg, Jeffrey; Divino, Celia M.; Kim, Michelle K.

doi:10.1097/mpa.0000000000001309

Cited by 5 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study of 72 cases of SBNET resections, Gonzalez et al ( 45 ) demonstrated that the presence of a mesenteric mass was significantly associated with lymph nodal and liver metastasis, lymphovascular invasion, T3 or T4 disease, and increased disease progression and death. Malik et al ( 46 ) also found that patients with a mesenteric mass were more likely to have advanced T status and confirmed that mesenteric involvement represented more extensive disease and was also associated with more aggressive treatment. If feasible, surgery was required for the primary tumor, regional LNs, and mesenteric masses.…”

Section: Discussionmentioning

confidence: 86%

Prognostic Performance of Different Lymph Node Staging Systems in Patients With Small Bowel Neuroendocrine Tumors

Jiang

Xie

et al. 2020

Front. Endocrinol.

View full text Add to dashboard Cite

Background: The prognostic significance of the lymph node (LN) classification for small bowel neuroendocrine tumors (SBNETs) remains unknown. The aim of the present study was to evaluate and compare the prognostic assessment of different LN staging systems. Methods: Patients with SBNETs were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The X-tile program was used to determine the cutoff value of the resected lymph nodes (RLNs), negative lymph nodes (NLNs), lymph node ratio (LNR), and the log odds of positive lymph nodes (LODDS). Survival analyses were performed using Kaplan–Meier curves with log-rank test. Logistic regression analysis was used to evaluate the differences between different periods. Univariate and multivariate Cox proportional hazards models were used to assess the prognostic value of different LN staging systems on cause-specific survival (CSS). The relative discriminative abilities of the different LN staging systems were assessed using the Akaike information criterion (AIC) and the Harrell consistency index (HCI). Result: A total of 3,680 patients were diagnosed with SBNETs between 1988 and 2014 from the SEER database. A significant difference over time (1988–1999 vs. 2000–2014) was seen in age ( P <0.001), tumor differentiation ( P <0.001), T stage ( P <0.001), and RLN ( P <0.001) subgroups. Multivariate Cox survival analysis identified that LN status stratified by the number of RLNs, NLNs, LNR, and LODDS all predicted CSS in patients with SBNETs (all P <0.05), whereas the number of positive lymph nodes (PLNs) failed ( P = 0.452). When assessed using categorical variables, LODDS staging systems showed the best prognostic performance (HCI: 0.766, AIC: 7,575.154) in the whole population. Further analysis based on different RLNs after eliminating the missing data showed that when the RLNs are <12, the LODDS (HCI: 0.769, AIC: 1,088.731) maintained the best prognostic performance as well when the RLNs are ≥12 (HCI: 0.835, AIC: 825.692). Among patients with LNR scores of 0 or 1, there was a residual heterogeneity of outcomes that were better stratified and characterized by the LODDS. Conclusion: LODDS was a better predicator of survival when LN status was stratified as a categorical variable and should be considered when assessing the prognosis of patients with SBNETs to allow a more reliable means to stratify patient survival.

show abstract

Section: Discussionmentioning

confidence: 86%

Prognostic Performance of Different Lymph Node Staging Systems in Patients With Small Bowel Neuroendocrine Tumors

Jiang

Xie

et al. 2020

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…This could also be related to the small size of our study population. Indeed, Malik et al [22] showed an association between the presence of an MM on pathological specimen and symptoms in 302 studied patients, but the authors mixed symptoms related to carcinoid and LTR symptoms. To clarify the results in the present series and because these 2 situations require 2 different treatments (somatostatin analogs for one and quick surgery for the other), we deliberately separated carcinoid symptoms and LTR symptoms.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Small Intestinal Neuroendocrine Neoplasm: Factors Associated with the Development of Local Tumor-Related Symptoms

et al. 2021

View full text Add to dashboard Cite

Introduction: Clinical presentations of small intestinal neuroendocrine neoplasms (SiNENs) can range from asymptomatic to life-threatening complications. Other than primary tumor(s), mesenteric mass (MM) can provide local tumor-related (LTR) symptoms. Although some expert centers propose routine primary resection to avoid complications in stage IV patients, some guidelines suggest avoiding primary tumor resection unless in the presence of symptoms. This study was aimed to identify factors associated with the presence or development of LTR symptoms. Methods: From 2012 to 2019, SiNEN patients with appropriate initial morphological imaging were included. All initial imaging was reviewed. Associations between factors and LTR symptoms were assessed by logistic regression. Results: Among 144 SiNEN patients, 66 met the inclusion criteria. Multivariate analysis identified on initial morphological imaging (i) any visible primary tumor (p < 0.01) and (ii) MM contact ≥180° with the superior mesenteric vessels (p ≤ 0.02), as independent factors associated with LTR symptoms in the whole study population as well as in the subgroup of primary resected patients. Among the 14 (21%) patients with both factors on initial cross-sectional conventional imaging, 12 (18%) were straightaway symptomatic at diagnosis and the remaining became symptomatic during the follow-up. All asymptomatic patients, without upfront surgery and without any predictive factor 16/18 (89%), stayed asymptomatic during the 2.7-year median follow-up. The absence of association between these 2 factors yielded a sensitivity of 100%, a specificity of 62%, and a negative predictive value of 100% for the occurrence of LTR symptoms. Conclusion: The presence of any visible primary tumor and/or MM superior mesenteric vessels contact ≥180° at initial cross-sectional imaging are 2 easily identifiable factors, which can help physicians for the decision-making regarding timing and type of surgery for SiNENs. Larger multicenter studies should endorse these results.

show abstract

“…Most patients with SI-NETs (nearly 80%) present nonspecific symptoms mainly related to the local effect of MLNM than to the primary tumor [ 4 , 5 , 66 ]. Among them, 12.5% to 33% need emergency surgery [ 5 , 12 , 67 ].…”

Section: Surgerymentioning

confidence: 99%

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Deguelte¹,

Perrier²,

Hammoutene³

et al. 2020

JCM

View full text Add to dashboard Cite

Small-intestinal neuroendocrine tumors (SI-NETs) are the most prevalent small bowel neoplasms with an increasing frequency. In the multimodal management of SI-NETs, surgery plays a key role, either in curative intent, even if R0 resection is feasible in only 20% of patients due to advanced stage at diagnosis, or palliative intent. Surgeons must be informed about the specific surgical management of SI-NETs according to their hormonal secretion, their usual dissemination at the time of diagnosis and the need for bowel-preserving surgery to avoid short bowel syndrome. The aim of this paper is to review the surgical indications and techniques, and perioperative and postoperative management of SI-NETs.

show abstract

Impact of Mesenteric Mass in Patients With Midgut Neuroendocrine Tumors

Cited by 5 publications

References 15 publications

Prognostic Performance of Different Lymph Node Staging Systems in Patients With Small Bowel Neuroendocrine Tumors

Prognostic Performance of Different Lymph Node Staging Systems in Patients With Small Bowel Neuroendocrine Tumors

Small Intestinal Neuroendocrine Neoplasm: Factors Associated with the Development of Local Tumor-Related Symptoms

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Contact Info

Product

Resources

About