Elevated Plasma Pancreastatin, but Not Chromogranin A, Predicts Survival in Neuroendocrine Tumors of the Duodenum.

Autor:	Woltering EA; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA. Electronic address: ewolte@lsuhsc.edu., Beyer DT; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA., Thiagarajan R; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA., Ramirez RA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA., Wang YZ; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA., Ricks MJ; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA., Boudreaux JP; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2016 Apr; Vol. 222 (4), pp. 534-42. Date of Electronic Publication: 2015 Dec 21.
DOI:	10.1016/j.jamcollsurg.2015.12.014
Abstrakt:	Background: Neuroendocrine tumors (NETs) of the duodenum are rare, heterogeneous, and often indolent neoplasms. We hypothesized that elevated pancreastatin levels are an indicator of a poor prognosis in well-differentiated duodenal NETs. Study Design: Data from patients diagnosed with a primary duodenal NET were analyzed. Patients that underwent esophogogastroduodenoscopy, endoscopic ultrasound, or exploratory surgery to localize their neoplasm and whose tumors were confirmed histologically were included. Results: Eighty-four patients were diagnosed with duodenal NETs from January 1991 to January 2014. Seventy-five percent and 21% of patients had their tumor localized by esophogogastroduodenoscopy and endoscopic ultrasound, respectively. The remaining 4% were localized during exploratory surgery. The 5-year Kaplan-Meier survival rate for the entire cohort (N = 84) was 80%. Survival sorted by normal vs abnormal pancreastatin level was statistically significant (p < 0.0001). Five-year survival rates were 94% and 37% for normal and abnormal pancreastatin, respectively. In contrast, survival sorted by normal vs abnormal plasma chromogranin A level was not statistically significant (p = 0.24). Conclusions: Patients with primary duodenal NETs have high 5-year survival rates. Serial monitoring of plasma pancreastatin levels can identify patients who have a poor prognosis. (Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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