| Autor: |
Uema D; Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, 01067 Dresden, Germany. deiseu@gmail.com., Alves C; Instituto do Cancer do Estado de Sao Paulo, Sao Paulo 01246-000, Brazil. carolinaacs@hotmail.com., Mesquita M; Instituto do Cancer do Estado de Sao Paulo, Sao Paulo 01246-000, Brazil. cellamesquita@yahoo.com.br., Nuñez JE; Instituto do Cancer do Estado de Sao Paulo, Sao Paulo 01246-000, Brazil. ejnunezr@gmail.com.; Department of Clinical Oncology, AC Camargo Cancer Center, Sao Paulo 01509-900, Brazil. ejnunezr@gmail.com., Siepmann T; Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, 01067 Dresden, Germany. timosiepmann.research@gmail.com., Angel M; Instituto Alexander Fleming, C1426ANZ Buenos Aires, Argentina. martin.angel@hotmail.com., Rego JFM; Hospital Universitário Onofre Lopes, Natal 59012-300, Brazil. juliana.oncologia@gmail.com., Weschenfelder R; Hospital Moinhos de Vento, Porto Alegre 90035-001, Brazil. rui.fernando.w@gmail.com., Rocha Filho DR; Hospital Universitário Walter Cantídio, Fortaleza 60420-570, Brazil. duilio.rocha@uol.com.br., Costa FP; Hospital Sirio Libanês, São Paulo 01308-050, Brazil. fredericoperegocosta@gmail.com., Barros M; Department of Clinical Oncology, AC Camargo Cancer Center, Sao Paulo 01509-900, Brazil. miltonb19@gmail.com., O'Connor JM; Hospital de Gastroenterología Bonorino Udaondo, C1264AAA Buenos Aires, Argentina. juanmanuel.oconnor@gmail.com., Illigens BM; Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Dresden International University, 01067 Dresden, Germany. minwootaurus@gmail.com.; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02114, USA. minwootaurus@gmail.com., Riechelmann RP; Department of Clinical Oncology, AC Camargo Cancer Center, Sao Paulo 01509-900, Brazil. Rachel.riechelmann@accamargo.org.br. |
| Abstrakt: |
The background to this study was that factors associated with carcinoid heart disease (CHD) and its impacts on overall survival (OS) are scantly investigated in patients (pts) with neuroendocrine tumors (NETs). In terms of materials and methods, a retrospective multicenter cohort study was conducted of factors associated with CHD in advanced NET pts with carcinoid syndrome (CS) and/or elevated urinary 5-hidroxyindole acetic acid (u5HIAA). CHD was defined as at least moderate right valve alterations. The results were the following: Among the 139 subjects included, the majority had a midgut NET (54.2%), 81.3% had CS, and 93% received somatostatin analogues. In a median follow-up of 39 months, 48 (34.5%) pts developed CHD, with a higher frequency in pts treated in public (77.2%) versus private settings (22.9%). In a multivariate logistic regression, unknown primary or colorectal NETs (Odds Ratio (OR) 4.35; p = 0.002), at least 50% liver involvement (OR 3.45; p = 0.005), and being treated in public settings (OR 4.76; p = 0.001) were associated with CHD. In a Cox multivariate regression, bone metastases (Hazard Ratio {HR} 2.8; p = 0.031), CHD (HR 2.63; p = 0.038), and a resection of the primary tumor (HR 0.33; p = 0.026) influenced the risk of death. The conclusions were the following: The incidence of CHD was higher in pts with a high hepatic tumor burden and in those treated in a public system. Delayed diagnosis and limited access to effective therapies negatively affected the lives of NET patients. |
