Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study

Wu, Lidong; Fu, Jianfei; Wan, Li; Pan, Jie; Lai, Shih-Kung; Zhong, Jing; Chung, Daniel C.; Wang, Liangjing

doi:10.18632/oncotarget.13632

Cited by 27 publications

(24 citation statements)

References 42 publications

(63 reference statements)

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“…In this study, we investigated several clinical characteristics that could potentially be prognostic predictors and survival outcomes of patients with adenocarcinoma of the jejunum and ileum. Consistent with previous studies, young age was a positive prognosis prediction factors in malignant tumours of the small bowel 22 , 31 . Additionally, marital status could be considered to be a protective factor, as we observed a Hazard Ratio of approximately 0.90 in married patients in comparison with single patients.…”

Section: Discussionsupporting

confidence: 91%

Surgical Management and Prognostic Prediction of Adenocarcinoma of Jejunum and Ileum

Xie

Zhou

Song

et al. 2017

Sci Rep

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We conducted a retrospective study based on the Surveillance, Epidemiology, and End Results Program (SEER) database to establish a novel nomogram prognostic prediction system and to estimate the association between overall survival and prognostic factors, as well as to explore surgical treatment strategies for adenocarcinoma of the jejunum and ileum. A total of 883 patients from the SEER database were included in this study. Eight potential prognostic factors were included in a nomogram model and discriminatory power and accuracy were examined using the Harrell’s C-index and Akaike Information Criterion (AIC) index. In comparison with the AJCC TNM staging system, the nomogram prediction system was more accurate and homogeneous (Harrell’s C-index, 0.731 vs. 0.667; AIC index, 4852.9 vs. 4913.723). For surgical management, resection of more than 12 local lymph nodes could improve the likelihood of survival. This study demonstrates that our nomogram model is more accurate and homogeneous than the traditional AJCC TNM staging system, and proper surgical strategies for mesenteric lymphadenectomy improve overall survival.

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Section: Discussionsupporting

confidence: 91%

Surgical Management and Prognostic Prediction of Adenocarcinoma of Jejunum and Ileum

Xie

Zhou

Song

et al. 2017

Sci Rep

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“…However, it is also important to note that although overall patients with advanced SI-NET may not benefit from prophylactic surgery, some patient populations might (Wu et al 2017). In order to be able to identify patients who might benefit from prophylactic surgery, more insight is needed on the development of MF (Norlen et al 2012, Niederle et al 2016.…”

Section: Discussionmentioning

confidence: 99%

Mesenteric fibrosis and palliative surgery in small intestinal neuroendocrine tumours

Blažević¹,

Zandee²,

Franssen³

et al. 2018

Endocrine-Related Cancer

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Mesenteric fibrosis (MF) surrounding a mesenteric mass is a hallmark feature of small intestinal neuroendocrine tumours (SI-NETs). Since this can induce intestinal obstruction, oedema and ischaemia, prophylactic resection of the primary tumour and mesenteric mass is often recommended. This study assessed the predictors for mesenteric metastasis and fibrosis and the effect of MF and palliative surgery on survival. A retrospective analysis of 559 patients with pathologically proven SI-NET and available CT-imaging data was performed. Clinical characteristics, presence of mesenteric mass and fibrosis on CT imaging and the effect of palliative abdominal surgery on overall survival were assessed. We found that MF was present in 41.4%. Older age, 5-HIAA excretion ≥67 μmol/24 h, serum CgA ≥121.5 μg/L and a mesenteric mass ≥27.5 mm were independent predictors of MF. In patients ≤52 years, mesenteric mass was less often found in women than in men (39% vs 64%, = 0.002). Corrected for age, tumour grade, CgA and liver metastasis, MF was not a prognostic factor for overall survival. In patients undergoing palliative surgery, metastasectomy of mesenteric mass or prophylactic surgery did not result in survival benefit. In conclusion, we confirmed known predictors of MF and mesenteric mass and suggest a role for sex hormones as women ≤52 years have less often a mesenteric mass. Furthermore, the presence of MF has no effect on survival in a multivariate analysis, and we found no benefit of metastasectomy of mesenteric mass or prophylactic surgery on overall survival.

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“…Tumors of small bowel origin tend to have a better prognosis [13] compared to NENs originating in the pancreas. The effect of other factors such as age, race [3], resectability [14], performance status [15] or even marital status [16] has similarly been examined in several publications. Most medical decisions nowadays consider tumor of origin, staging, but also tumor differentiation and mitotic indices (values that have formed the basis of the current grading system [17]).…”

Section: Introductionmentioning

confidence: 99%

Effect of metastatic site on survival in patients with neuroendocrine neoplasms (NENs). An analysis of SEER data from 2010 to 2014

et al. 2020

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Background: Neuroendocrine neoplasms (NENs) display variable behaviors based on origin and grade. We assumed that both tumor origin and the location of metastasis may play a role in survival. Methods: We queried the SEER database (2010-2014) for patients with an established diagnosis of NENs and documented site of metastasis and identified 2005 patients. Overall survival (OS) at the time points were estimated by the Kaplan-Meier method Cox proportional-hazards models were used to evaluate the relationship of the interested variables and OS. Results: Lung, liver, bone and brain metastases were observed in 9, 77, 7 and 6% of metastatic patients respectively. In the multivariate model, metastasis locations were significantly associated with worse survival (liver HR: 1.677 (1.226-2.294); (bone metastasis HR: 1.412 (0.965-2.065); brain HR: 1.666 (1.177-2.357)). We produced a scoring system based on site of origin, metastasis location, age, gender, histology and tumor size that can stratify metastatic NEN patients in low, intermediate and high-risk categories to help physicians with decision making. Conclusion: Site of metastasis plays an important role in survival of metastatic NEN patients independent of commonly described prognostic factors and should be considered in survival estimates.

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Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study

Cited by 27 publications

References 42 publications

Surgical Management and Prognostic Prediction of Adenocarcinoma of Jejunum and Ileum

Surgical Management and Prognostic Prediction of Adenocarcinoma of Jejunum and Ileum

Mesenteric fibrosis and palliative surgery in small intestinal neuroendocrine tumours

Effect of metastatic site on survival in patients with neuroendocrine neoplasms (NENs). An analysis of SEER data from 2010 to 2014

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