Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications
| Autor: | Joseph Davar, Charlotte Leigh, Martyn Caplin, Aimee R Hayes, Dalvinder Mandair, Man Liu, Luke Furtado O'Mahony, Eleni Armeni, Christos Toumpanakis, Jie Chen, Luke Sullivan, Shaunak Navalkissoor |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Asymptomatic Gastroenterology 030218 nuclear medicine & medical imaging Heart Neoplasms 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine Endocrinology Internal medicine Outcome Assessment Health Care medicine Palpitations Natriuretic peptide Humans Aged Retrospective Studies Aged 80 and over Endocrine and Autonomic Systems business.industry Proportional hazards model Middle Aged Prognosis medicine.disease Neuroendocrine Tumors Heart failure Concomitant Cohort Radionuclide therapy Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Neuroendocrinology. 111:907-924 |
| ISSN: | 1423-0194 0028-3835 |
| DOI: | 10.1159/000510444 |
| Popis: | Background: Cardiac metastases (CM) from neuroendocrine tumours (NET) are rare; however, with the introduction of new molecular imaging modalities, such as 68Ga-DOTATATE PET-CT for NET diagnosis and re-staging, they are now identified more frequently. This study presents a single-institution experience on the NET CM characteristics, management, and prognostic implications. Methods: Between January 1998 and January 2020, 25 NET patients with CM were treated in our unit. A retrospective review of electronic records was performed. Overall survival (OS) was assessed by the Kaplan-Meier method. Cox regression models were used to evaluate the association of various clinical variables with OS. Results: The median age in the NET CM cohort was 64 years, with small intestine being the most common primary (84%). Nearly half of the patients suffered either from shortness of breath (48%) or had palpitations (12%). Peptide receptor radionuclide therapy (PRRT) was applied in more than half of the patients (64%), who had an improved trend for a longer median OS compared to those patients who did not receive PRRT (76.0 vs. 14.0 months, p = 0.196). The multivariate analysis demonstrated that concomitant skeletal or pancreatic metastases, as well as N-terminal pro-B-type natriuretic peptide (NT pro-BNP) >2 × upper limit of normal (ULN), were independent poor prognosticators. Conclusions: Clinical features of NET CM ranged from asymptomatic patients to heart failure. Concomitant bone or pancreatic metastases and NT pro-BNP levels >2 ULN predicted shorter survival time. PRRT serves as a feasible therapy with promising survival benefits; however, more data are needed. |
| Databáze: | OpenAIRE |
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