[Management of treatment in patients with neuroendocrine neoplasmas of digestive tract]

Vnitr Lek. 2015 Dec;61(12 Suppl 5):5S12-20.
[Article in Slovak]

Abstract

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.

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use*
  • Biomarkers, Tumor / blood*
  • Chromogranin A / blood
  • Endoscopy, Digestive System*
  • Female
  • Gastrointestinal Neoplasms / blood
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / therapy*
  • Humans
  • Hydroxyindoleacetic Acid / blood
  • Interferons / therapeutic use*
  • Intestine, Small / pathology
  • Intestine, Small / surgery*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / blood
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / therapy*
  • Prognosis
  • Radiotherapy / methods*

Substances

  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Chromogranin A
  • Hydroxyindoleacetic Acid
  • Interferons