Neuroendocrine Gastroenteropancreatic Tumors: Where Are We?

Surg Laparosc Endosc Percutan Tech. 2017 Feb;27(1):36-41. doi: 10.1097/SLE.0000000000000362.

Abstract

Aims: Neuroendocrine gastroenteropancreatic tumors are infrequently found neoplasms. Our objective was to analyze the survival rates for all sites that they occur in by studying different variables.

Materials and methods: A retrospective study was carried out using records for a 7-year period from January 1, 2008 to December 31, 2014 on neuroendocrine gastroenteropancreatic tumors patients diagnosed at the Pontevedra-Salnés Hospital Complex. The variables used were as follows: age at diagnosis, tumor size, presence or absence of metastases at diagnosis, cell proliferation index, Ki-67 of each tumor, treatments received, postdiagnosis survival time, existence or not of tumor progression, and time from diagnosis to progression and from diagnosis to mortality. In relation to treatments, the information recorded was whether the treatment was endoscopic, surgical, or pharmacological.

Results: Ninety-three neuroendocrine tumors made up a ratio of 4.42 cases per 100,000 inhabitants per annum. The median patient follow-up time was 44 months. The overall 5-year survival rate for patients who were followed up for a minimum of 60 months (49 patients) was 65.3%. The progression-free survival was 75.6% for 41 patients who were followed up for a minimum of 60 months. The survival rate for patients receiving endoscopic treatment was 100%, as there was no patient mortality recorded for those treated by endoscopic resection during the follow-up period.

Conclusion: Pancreatic neuroendocrine tumors may be managed conservatively in elderly patients by either monitoring them with imaging studies or treating them with somatostatin analogs. In the case of digestive tract tumors (stomach, duodenum, and rectum) that meet the criteria for endoscopic resection, this is a reliable and safe technique in the long term.

MeSH terms

  • Age of Onset
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Endoscopy, Digestive System / mortality
  • Epidemiologic Methods
  • Female
  • Gastrointestinal Neoplasms / mortality*
  • Gastrointestinal Neoplasms / therapy
  • Humans
  • Intestinal Neoplasms / mortality*
  • Intestinal Neoplasms / therapy
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neuroendocrine Tumors / mortality*
  • Neuroendocrine Tumors / therapy
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / therapy
  • Spain / epidemiology
  • Stomach Neoplasms / mortality*
  • Stomach Neoplasms / therapy

Substances

  • Ki-67 Antigen

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor