Specific Growth Rate as a Predictor of Survival in Pancreatic Neuroendocrine Tumors: A Multi-institutional Study from the United States Neuroendocrine Study Group.
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
20
06
2019
pubmed:
25
4
2020
medline:
5
5
2021
entrez:
25
4
2020
Statut:
ppublish
Résumé
Pancreatic neuroendocrine tumors (PNETs) are often indolent; however, identifying patients at risk for rapidly progressing variants is critical, particularly for those with small tumors who may be candidates for expectant management. Specific growth rate (SGR) has been predictive of survival in other malignancies but has not been examined in PNETs. A retrospective cohort study of adult patients who underwent PNET resection from 2000 to 2016 was performed utilizing the multi-institutional United States Neuroendocrine Study Group database. Patients with ≥ 2 preoperative cross-sectional imaging studies at least 30 days apart were included in our analysis (N = 288). Patients were grouped as "high SGR" or "low SGR." Demographic and clinical factors were compared between the groups. Kaplan-Meier and log-rank analysis were used for survival analysis. Cox proportional hazard analysis was used to assess the impact of various clinical factors on overall survival (OS). High SGR was associated with higher T stage at resection, shorter doubling time, and elevated HbA1c (all P ≤ 0.01). Patients with high SGR had significantly decreased 5-year OS (63 vs 80%, P = 0.01) and disease-specific survival (72 vs 91%, P = 0.03) compared to those with low SGR. In patients with small (≤ 2 cm) tumors (N = 106), high SGR predicted lower 5-year OS (79 vs 96%, P = 0.01). On multivariate analysis, high SGR was independently associated with worse OS (hazard ratio 2.67, 95% confidence interval 1.05-6.84, P = 0.04). High SGR is associated with worse survival in PNET patients. Evaluating PNET SGR may enhance clinical decision-making, particularly when weighing expectant management versus surgery in patients with small tumors.
Sections du résumé
BACKGROUND
BACKGROUND
Pancreatic neuroendocrine tumors (PNETs) are often indolent; however, identifying patients at risk for rapidly progressing variants is critical, particularly for those with small tumors who may be candidates for expectant management. Specific growth rate (SGR) has been predictive of survival in other malignancies but has not been examined in PNETs.
METHODS
METHODS
A retrospective cohort study of adult patients who underwent PNET resection from 2000 to 2016 was performed utilizing the multi-institutional United States Neuroendocrine Study Group database. Patients with ≥ 2 preoperative cross-sectional imaging studies at least 30 days apart were included in our analysis (N = 288). Patients were grouped as "high SGR" or "low SGR." Demographic and clinical factors were compared between the groups. Kaplan-Meier and log-rank analysis were used for survival analysis. Cox proportional hazard analysis was used to assess the impact of various clinical factors on overall survival (OS).
RESULTS
RESULTS
High SGR was associated with higher T stage at resection, shorter doubling time, and elevated HbA1c (all P ≤ 0.01). Patients with high SGR had significantly decreased 5-year OS (63 vs 80%, P = 0.01) and disease-specific survival (72 vs 91%, P = 0.03) compared to those with low SGR. In patients with small (≤ 2 cm) tumors (N = 106), high SGR predicted lower 5-year OS (79 vs 96%, P = 0.01). On multivariate analysis, high SGR was independently associated with worse OS (hazard ratio 2.67, 95% confidence interval 1.05-6.84, P = 0.04).
CONCLUSION
CONCLUSIONS
High SGR is associated with worse survival in PNET patients. Evaluating PNET SGR may enhance clinical decision-making, particularly when weighing expectant management versus surgery in patients with small tumors.
Identifiants
pubmed: 32328982
doi: 10.1245/s10434-020-08497-4
pii: 10.1245/s10434-020-08497-4
pmc: PMC10182416
mid: NIHMS1886970
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3915-3923Subventions
Organisme : NCI NIH HHS
ID : K12 CA090625
Pays : United States
Références
J Surg Oncol. 1999 Jul;71(3):140-6
pubmed: 10404129
Science. 2011 Mar 4;331(6021):1199-203
pubmed: 21252315
Cancer. 1994 Oct 15;74(8):2239-44
pubmed: 7922975
World J Gastrointest Endosc. 2017 Apr 16;9(4):153-161
pubmed: 28465781
Cancer. 1961 Nov-Dec;14:1272-94
pubmed: 13909709
Endocr Relat Cancer. 2008 Jun;15(2):409-27
pubmed: 18508996
J Gastrointest Surg. 2015 Jan;19(1):117-23; discussion 123
pubmed: 25155459
Trends Biochem Sci. 2013 Aug;38(8):394-402
pubmed: 23850066
Ann Surg Oncol. 2013 Sep;20(9):2815-21
pubmed: 23771245
Curr Opin Oncol. 2012 Jan;24(1):46-55
pubmed: 22080942
Cancer. 1989 Jun 1;63(11):2207-10
pubmed: 2541886
Neuroendocrinology. 2016;103(2):153-71
pubmed: 26742109
Am J Clin Oncol. 2012 Dec;35(6):549-56
pubmed: 21659833
Oncotarget. 2017 May 23;8(21):35368-35375
pubmed: 28430639
Am J Surg Pathol. 2014 Apr;38(4):437-47
pubmed: 24503751
Surgery. 2013 Oct;154(4):785-91; discussion 791-3
pubmed: 24074416
Cancer Treat Rev. 2018 Jun;67:1-9
pubmed: 29746922
Nat Commun. 2017 Oct 13;8(1):922
pubmed: 29030545
J Gastrointest Surg. 2013 Apr;17(4):739-47
pubmed: 23292461
Sci Rep. 2016 Oct 26;6:36073
pubmed: 27782199
Int J Cancer. 2008 Aug 15;123(4):867-73
pubmed: 18491401
J Clin Endocrinol Metab. 2014 Nov;99(11):E2387-91
pubmed: 25210877
Pancreas. 2010 Aug;39(6):735-52
pubmed: 20664472
Ophthalmology. 2000 Aug;107(8):1443-9
pubmed: 10919885
Nat Rev Dis Primers. 2016 Apr 21;2:16022
pubmed: 27158978
Biomed Res Int. 2015;2015:598134
pubmed: 26421295
Sci Rep. 2018 May 8;8(1):7271
pubmed: 29739948
BMC Cancer. 2019 Jan 14;19(1):66
pubmed: 30642293
J Mol Endocrinol. 2013 Dec 19;52(1):R51-66
pubmed: 24049067
Ann Surg. 2014 Feb;259(2):204-12
pubmed: 23673766
J Gastrointest Surg. 2017 May;21(5):855-866
pubmed: 28255853
Ann Surg. 2007 Feb;245(2):273-81
pubmed: 17245182
Gastroenterology. 2008 Apr;134(4):981-7
pubmed: 18395079
J Eur Acad Dermatol Venereol. 2011 May;25(5):618-20; author reply 620
pubmed: 21492248
Cancer Res. 2007 Apr 15;67(8):3970-5
pubmed: 17440113
World J Gastroenterol. 2016 Dec 7;22(45):10015-10023
pubmed: 28018109
J Natl Compr Canc Netw. 2015 Jan;13(1):78-108
pubmed: 25583772
Pancreas. 2001 May;22(4):366-9
pubmed: 11345136
Int J Radiat Oncol Biol Phys. 2014 Jul 1;89(3):532-8
pubmed: 24929163
Ann Surg. 2005 May;241(5):776-83; discussion 783-5
pubmed: 15849513
Ann Oncol. 2016 Jan;27(1):68-81
pubmed: 26487581
Ann Surg Oncol. 2015 Mar;22(3):1000-7
pubmed: 25190116