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Survival Analysis and Prognostic Factors for Neuroendocrine Tumors in Turkey

  • Yucel, Birsen (Radiation Oncology Department, Cumhuriyet University School of Medicine) ;
  • Babacan, Nalan Akgul (Medical Oncology Department, Cumhuriyet University School of Medicine) ;
  • Kacan, Turgut (Medical Oncology Department, Cumhuriyet University School of Medicine) ;
  • Eren, Ayfer Ay (Radiation Oncology Department, Cumhuriyet University School of Medicine) ;
  • Eren, Mehmet Fuat (Radiation Oncology Department, Cumhuriyet University School of Medicine) ;
  • Bahar, Seher (Radiation Oncology Department, Cumhuriyet University School of Medicine) ;
  • Celasun, Mustafa Gurol (Medical Oncology Department, Cumhuriyet University School of Medicine) ;
  • Seker, Mehmet Metin (Medical Oncology Department, Cumhuriyet University School of Medicine) ;
  • Hasbek, Zekiye (Nuclear Medicine Department, Cumhuriyet University School of Medicine)
  • Published : 2013.11.30

Abstract

Background: This study aimed to determine the demographical distribution, survival and prognostic factors for neuroendocrine tumors monitored in our clinic. Materials and Methods: Data for 52 patients who were admitted to Cumhuriyet University Medical Faculty Training Research and Practice Hospital Oncology Center between 2006 and 2012 and were diagnosed and treated for neuroendocrine tumors were investigated. Results: Of the total, 30 (58%) were females and 22 (42%) were males. The localization of the disease was gastroenteropancreatic in 29 (56%) patients and other sites in 23 (44%). The most frequently involved organ in the gastroenteropancreatic system was the stomach (n=10, 19%) and the most frequently involved organ in other regions was the lungs (n=10, 19%). No correlation was found between immunohistochemical staining for proteins such as chromogranin A, synaptophysin, and NSE and the grade of the tumor. The patients were followed-up at a median of 24 months (1-90 months). The three-year overall survival rate was 71%: 100% in stage I, 88% in stage II, 80% in stage III, and 40% in stage IV. The three-year survival rate was 78% in tumors localized in the gastroenteropancreatic region, and 54% in tumors localized in other organs. In the univariate analysis, gender, age, performance status of the patients, grade, localization, surgical treatment, and neutrophil/lymphocyte ratio (${\leq}5$ versus >5) affected the prognosis of the patients. Conclusions: Most of the tumors were localized in the gastroenteropancreatic region, and the three-year survival rate in tumors localized in this region was better than the tumors localized in other sites. Surgical treatment was a positive independent prognostic factor, whereas Grade 3 and a neutrophil/lymphocyte ratio of >5 were negative independent prognostic factors.

Keywords

Neuroendocrine tumors;survival;prognostic factors;Turkey

References

  1. Chou WC, Hung YS, Hsu JT, et al (2012). Chromogranin a is a reliable biomarker for gastroenteropancreatic neuroendocrine tumors in an Asian population of patients. Neuroendocrinology, 95, 344-50. https://doi.org/10.1159/000333853
  2. Chua W, Charles K, Baracos V, Clarke S (2011). Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Bri J Cancer, 104, 1288-95. https://doi.org/10.1038/bjc.2011.100
  3. Dogan M, Yalcin B, Ozdemir NY, et al (2012). Retrospective analysis of seventy-one patients with neuroendocrine tumor and review of the literature. Med Oncol, 29, 2021-6. https://doi.org/10.1007/s12032-011-9986-9
  4. Hauso O, Gustafsson BI, Kidd M, et al (2008). Neuroendocrine tumor epidemiology. Cancer, 113, 2655-64. https://doi.org/10.1002/cncr.23883
  5. Jensen KH, Hilsted L, Jensen C, et al (2013). Chromogranin A is a sensitive marker of progression or regression in ileo-cecal neuroendocrine tumors. Scandinavian J Gastroenterol, 48, 70-7. https://doi.org/10.3109/00365521.2012.733953
  6. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S (2010). The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas, 39, 707-12. https://doi.org/10.1097/MPA.0b013e3181ec124e
  7. Kloppel G, Rindi G, Anlauf M, Perren A, Komminoth P (2007). Site-specific biology and pathology of gastroenteropancreatic neuroendocrine tumors. Virchows Archiv, 451, 9-27. https://doi.org/10.1007/s00428-007-0461-0
  8. Korse CM, Taal BG, Vincent A, et al (2012). Choice of tumour markers in patients with neuroendocrine tumours is dependent on the histological grade. A marker study of Chromogranin A, Neuron specific enolase, Progastrin-releasing peptide and cytokeratin fragments. Eur J Cancer, 48, 662-71. https://doi.org/10.1016/j.ejca.2011.08.012
  9. Kulke MH, Siu LL, Tepper JE, et al (2011). Future directions in the treatment of neuroendocrine tumors: consensus report of the National Cancer Institute Neuroendocrine Tumor clinical trials planning meeting. J Clin Oncol, 29, 934-43. https://doi.org/10.1200/JCO.2010.33.2056
  10. Lepage C, Rachet B, Coleman MP (2007). Survival from malignant digestive endocrine tumors in England and Wales: a population-based study. Gastroenterol, 132, 899-904. https://doi.org/10.1053/j.gastro.2007.01.006
  11. Lepage C, Ciccolallo L, De Angelis R, et al (2010). European disparities in malignant digestive endocrine tumours survival. Int J Cancer, 126, 2928-34.
  12. Lloyd RV (2003). Practical markers used in the diagnosis of neuroendocrine tumors. Endocrine Pathol, 14, 293-301. https://doi.org/10.1385/EP:14:4:293
  13. Maggard MA, O’Connell JB, Ko CY (2004). Updated population-based review of carcinoid tumors. Ann Surg, 240, 117. https://doi.org/10.1097/01.sla.0000129342.67174.67
  14. Massironi S, Spampatti MP, Rossi RE, et al (2012). Circulating Markers in Gastroenteropancreatic Neuroendocrine Tumors (GEP NETs). In: A. Lowell (ed.), NEUROENDOCRINE TUMOR. In Tech, Croatia.
  15. Metz DC, Jensen RT (2008). Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology, 135, 1469-92. https://doi.org/10.1053/j.gastro.2008.05.047
  16. Mougey AM, Adler DG (2007). Neuroendocrine tumors: review and clinical update. Hospital Physician, 43, 12.
  17. Ozyalvacli G, Pasaoglu E, Bozkurt ER (2012). Gastrointestinal and Pancreatic Neuroendocrine Tumors Prognostic Parameters. Abant Med J, 1, 69-72. https://doi.org/10.5505/abantmedj.2012.02411
  18. Rindi G, Arnold R, Bosman F, et al (2010). Nomenclature and classification of neuroendocrine neoplasms of the digestive system. WHO Classification of Tumours of the Digestive System, 13-4.
  19. Ropponen KM, Eskelinen MJ, Lipponen PK, Alhava E, Kosma VM (1997). Prognostic value of tumour infiltrating lymphocytes (TILs) in colorectal cancer. J Pathol, 182, 318-24. https://doi.org/10.1002/(SICI)1096-9896(199707)182:3<318::AID-PATH862>3.0.CO;2-6
  20. Sarraf KM, Belcher E, Raevsky E, et al (2009): Neutrophil/lymphocyte ratio and its association with survival after complete resection in non.small cell lung cancer. J Thoracic and Cardiovascular Surg, 137, 425-8. https://doi.org/10.1016/j.jtcvs.2008.05.046
  21. Shayanfar N, Shahzadi SZ (2009). Immunohistochemical assessment of neuroendocrine differentiation in colorectal carcinomas and Its relation with age, sex and grade plus stage. Iranian J Pathol, 4, 167-71.
  22. Shimada H, Takiguchi N, Kainuma O, et al (2010). High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer, 13, 170-6. https://doi.org/10.1007/s10120-010-0554-3
  23. Stojsic J, Stevic R, Kontic M, et al (2011). Large cell lung carcinoma with unusual imaging feature, immunophenotype and genetic finding. Pathol and Oncol Res, 17, 175-9. https://doi.org/10.1007/s12253-010-9272-8
  24. Stoyianni A, Pentheroudakis G, Pavlidis N (2011). Neuroendocrine carcinoma of unknown primary: a systematic review of the literature and a comparative study with other neuroendocrine tumors. Cancer Treatment Rev, 37, 358-65. https://doi.org/10.1016/j.ctrv.2011.03.002
  25. Tavassoli FA, Devilee P (2003). Pathology and genetics: tumours of the breast and female genital organs. International Agency for Research on Cancer, Lyon.
  26. Travis WD, Rush W, Flieder DB, et al (1998). Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol, 22, 934-44. https://doi.org/10.1097/00000478-199808000-00003
  27. Walsh S, Cook E, Goulder F, Justin T, Keeling N (2005). Neutrophil lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol, 91, 181-4. https://doi.org/10.1002/jso.20329
  28. Yao JC, Hassan M, Phan A, et al (2008). One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. J Clin Oncol, 26, 3063-72. https://doi.org/10.1200/JCO.2007.15.4377
  29. Yao JC, Shah MH, Ito T, et al (2011). Everolimus for advanced pancreatic neuroendocrine tumors. New England J Med, 364, 514-23. https://doi.org/10.1056/NEJMoa1009290
  30. Yao JC, Lagunes DR, Kulke MH (2013). Targeted Therapies in Neuroendocrine Tumors (NET): Clinical Trial Challenges and Lessons Learned. The Oncologist, 18, 525-32. https://doi.org/10.1634/theoncologist.2012-0434
  31. Yildiz O, Ozguro.lu M, Yanmaz T, et al (2010). Gastroenteropancreatic neuroendocrine tumors: 10-year experience in a single center. Med Oncol, 27, 1050-6. https://doi.org/10.1007/s12032-009-9332-7
  32. Yildiz O, Serdengecti S (2012). Gastrointestinal Neuroendocrine Tumors. In: A. Lowell (ed.), Neuroendocrine Tumor. In Tech, Croatia.
  33. Zjacic-Rotkvic V, Berkovic M (2010). Neuroendocrine tumors (NET) of the gastrointestinal system: diagnosis and therapy. Acta Clin Croatica, 49, 224-5.

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