Management of treatment in patients with neuroendocrine neoplasmas of digestive tract
Authors:
Soňa Kiňová 1; Martina Kováčová 1; Martin Čaprnda 2; Michal Koreň 1
Authors‘ workplace:
I. interná klinika LF UK a UN Bratislava, Slovenská republika, prednostka doc. MUDr. Soňa Kiňová, PhD.
1; II. interná klinika LF UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Ľudovít Gašpar, CSc.
2
Published in:
Vnitř Lék 2015; 61(Suppl 5): 12-20
Category:
Original Contributions
Overview
Neuroendocrine neoplasmas are a form of cancer arising from cells of diffuse neuroendocrine system. They produce peptides or amines that act as hormones or neurotransmitters. Incidence of NENs is relatively low. Diagnostic work-up and treatment requires a multidisciplinary team approach. The aim of this study was an analysis of data from patients with well-differentiated neuroendocrine neoplasmas of gastrointestinal tract. The study included patients followed up from 1998 to 2013 with histologically confirmed well-differentiated digestive neuroendocrine neoplasm with low or intermediate malignant potential. 97 patients were included; 34 men (35.1 %) and 63 women (64.9 %). In patients being diagnosed after 2005 interferon treatment is significantly less used than endoscopic and peptide receptor radionuclide therapy. We have identified more appropriate discriminant values of 5-HIAA and chromogranin A (6.8 mg/24 hours; 70 ng/ml) for predicting the presence of metastases at the time of diagnosis. We have identified following risk factors for overall mortality: liver metastases, presence of diarrhea, flush, small bowel primary tumor, high values of CgA and 5-HIAA at the time of diagnosis (5-HIAA > 520.52 mg/24 hours, CgA > 174.5 ng/ml). Surgical treatment was found to be a positive prognostic factor.
Key words:
chromogranin A – 5-hydroxyindoleacetic acid – neuroendocrine neoplasm
Sources
1. Caplin ME, Pavel M, Ćwikła JB et al. CLARINET Investigators. Lanreotide in Metastatic Enteropancreatic Neuroendocrine Tumors. N Engl J Med 2014; 371(3): 224–233.
2. Godwin JD 2nd. Carcinoid tumors. An analysis of 2837 cases. Cancer 1975; 36(2): 560–569.
3. Kiňová S, Kekeňák L, Kováčová E et al. Multidisciplinárny prístup k liečbe gastroenteropankreatických neuroendokrinných tumorov. Vnitř Lék 2010; 56(9 Suppl): S946-S950.
4. Kiňová S, Hulín I. Choroby tráviaceho systému. ProLitera: Bratislava 2011. ISBN 978–80–970253–5-9.
5. Kwekkeboom DJ, Krenning EP, Lebtahi R et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Peptide Receptor Radionuclide Therapy with Radiolabeled Somatostatin Analogs. Neuroendocrinology 2009; 90(2): 220–226.
6. Maiuri F, Cappabianca P, Del Basso De Caro M et al. Single brain metastases of carcinoid tumors. J Neurooncol 2004; 66(3): 327–332.
7. Marshall JB, Bodnarchuk G. Carcinoid tumors of the gut: Our experience over three decades and review of the literature (Review). J Clin Gastroenterol 1993; 16(2): 123–129.
8. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97(4): 934–959.
9. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine Tumors. V. 1. 2012. Dostupné z WWW: <http://www.nccn.org/professionals/physician_gls/f_guidelines.asp>.
10. Oberg K. Pancreatic endocrine tumors. Semin Oncol 2010; 37(6): 594–618.
11. Pavel M, Baudin E, Couvelard A et al. ENETS Consensus Guidelines for the Management of Patients with Liver and Other Distant Metastases from Neuroendocrine Neoplasms of Foregut, Midgut, Hindgut, and Unknown Primary. Neuroendocrinology 2012; 95(2): 157–176.
12. Rinke A, Muller HH, Schade-Brittinger C et al. Placebo-Controlled, Double-Blind, Prospective, Randomized Study on the Effect of Octreotide LAR in the Control of Tumor Growth in Patients With Metastatic Neuroendocrine Midgut Tumors: A Report From the PROMID Study Group. J Clin Oncol 2009; 27(28): 4656–4663.
13. Steinmüller T, Kianmanesh R, Falconi M et al. Consensus Guidelines for the Management of Patients with Liver Metastases from Digestive (Neuro)endocrine Tumors: Foregut, Midgut, Hindgut, and Unknown Primary. Neuroendocrinology 2008; 87(1): 47–62.
14. Wagnerova M. Neuroendokrinné nádory z pohľadu onkológa. Onkológia (Bratisl) 2011; 6(4): 205–210.
15. Yao JC, Hassan M, Phan A et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008; 26(18): 3063–3072.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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