ECE2011 Poster Presentations Endocrine tumours and neoplasia (37 abstracts)
Significant prognostic survival factors in patients with pancreatic neuroendocrine tumors
B Popovic 1 , Dj Macut 1 , M Petakov 1 , I Bozic 1 , T Bogavac 1 , S Ognjanovic 1 , T Isailovic 1 , V Elezovic 1 , Marijan Micev 2 , Nemanja Menkovic 3 & Svetozar Damjanovic 1
1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 2Clinic for Digestive Surgery, Belgrade, Serbia; 3Centre for Radiology and Magnetic Resonance, Belgrade, Serbia.
Introduction: Pancreatic neuroendocrine tumors (PNETs) are generally clinically more indolent than adenocarcinomas. But relevant, clinically applicable prognostic survival factors still need to be more precisely defined.
Aim: To identify survival factors in patients with PNETs.
Methods: We analyzed 66 patients with PNETs (52.62±13.3 years old) treated at our department during 2003–2010. Patients with insulinomas were not included in survival analysis unless manifesting malignant behavior. Kaplan–Meier method was used for univariate survival analysis, and Cox regression model for the estimation of influence of risk factors.
Results: Minority of PNETs were hormonally active (13 insulinomas, 7 somatostatinomas, 6 gastrinomas). Majority (53.7%) presented with metastatic disease, in stage IV according to TNM classification. According to WHO criteria, majority were well-differentiated neuroendocrine carcinomas (48.4%). Nine patients (13.6%) had genetically confirmed MEN1 syndrome. Primary tumor was operated in 36 patients (54.5%). Overall median survival was 73 months (2–180 months) with 5-year survival of 66.7%. Significantly shorter survival was noted in patients with metastatic disease at presentation (P=0.025), those who did not underwent primary tumor operation (P=0.018), tumors with higher mitotic count (P=0.001), higher proliferation index Ki-67 (P<0.001), and more aggressive behavior as characterized by the WHO group (P<0.001). Primary tumor size, hormonal activity, heritability and tumor stage had no significant influence on survival. Significant independent predictor of mortality was group according to WHO classification. (HR 4.722; (95% CI 1.746–12.771), P=0.002).
Conclusion: Biology of PNETs is best reflected by the criteria of WHO classification. Important favorable survival factor is operation of primary tumor, despite the presence of metastatic disease. Tumor stage, according to TNM classification, did not affect survival of our patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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