
The Library
Lung metastases in patients with well-differentiated gastroenteropancreatic neuroendocrine neoplasms : an appraisal of the validity of thoracic imaging surveillance
Tools
Daskalakis, Kosmas, Tsoli, Marina, Srirajaskanthan, Raj, Chatzellis, Eleftherios, Alexandraki, Krystallenia, Angelousi, Anna, Pizanias, Michail, Randeva, Harpal S., Kaltsas, Gregory and Weickert, Martin O. (2019) Lung metastases in patients with well-differentiated gastroenteropancreatic neuroendocrine neoplasms : an appraisal of the validity of thoracic imaging surveillance. Neuroendocrinology, 108 (4). pp. 308-316. doi:10.1159/000497183 ISSN 0028-3835.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.1159/000497183
Abstract
Background/Aims: To evaluate the impact of lung metastases (LM) on overall survival (OS) in well-differentiated (WD) stage IV gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) patients along with developing surveillance strategies for thoracic imaging. Methods: Thirty-four patients with LM, from 3 centres, were identified (22 small intestine/12 pancreatic; 17 grade 1/15 grade 2/2 of unknown grade). For comparison, we used 106 stage IV WD, grade 1 and 2 GEP-NEN patients with metastatic disease confined in the abdomen. Results: LM prevalence was 4.9% (34/692). Eleven patients (32%) presented with synchronous LM whereas 23 (68%) developed metachronous LM at a median of 25 months (range 1–150 months). Patients with metachronous LM had already established liver and/or para-aortic lymph node metastases. Eighteen of 23 patients (78%) with metachronous LM exhibited concomitant progression in the abdomen. Median OS of WD GEP-NEN patients with LM was shorter than for those with stage IV disease without extra-abdominal metastases (56 [95% CI 40.6–71.6] vs. 122.7 [95% CI 70.7–174.8] months; log-rank p = 0.001). Among patients with progressive stage IV disease, the subset of patients with LM exhibited shorter OS (log-rank p = 0.005). LM were also confirmed as an independent prognostic factor for survival in multivariable analysis (HR 0.18; 95% CI 0.07–0.45; p < 0.0001). Conclusion: LM, although relatively rare in patients with WD stage IV GEP-NENs, may impact patients’ outcome. The development of metachronous LM is associated with concomitant disease progression in established abdominal metastases in most patients. These patient-related parameters could be utilized for a stratified surveillance approach, mainly reserving thoracic imaging for GEP-NEN patients with progressive disease in the abdomen.
Item Type: | Journal Article | ||||
---|---|---|---|---|---|
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||
Journal or Publication Title: | Neuroendocrinology | ||||
Publisher: | Karger | ||||
ISSN: | 0028-3835 | ||||
Official Date: | June 2019 | ||||
Dates: |
|
||||
Volume: | 108 | ||||
Number: | 4 | ||||
Page Range: | pp. 308-316 | ||||
DOI: | 10.1159/000497183 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
![]() |
View Item |