ECE2014 Poster Presentations Endocrine tumours and neoplasia (99 abstracts)
Factors influencing survival of patients diagnosed with gastro-entero-pancreatic neuroendocrine tumors in Krakow and Krakow district area
Malgorzata Trofimiuk-Muldner 1, , Ewelina Lewkowicz 1 , Dorota Pach 1, , Agnieszka Kieltyka 3 , Agnieszka Stefanska 2 , Anna Sowa-Staszczak 2 , Aleksandra Gilis-Januszewska 1, & Alicja Hubalewska-Dydejczyk 1,
1Chair and Department of Endocrinology, Medical College, Jagiellonian University, Krakow, Poland; 2Department of Endocrinology, University Hospital in Krakow, Krakow, Poland; 3Chair of Epidemiology and Preventive Medicine, Medical College, Jagiellonian University, Krakow, Poland.
Abstract Identification of factors influencing survival of the gastro-entero-pancreatic neuroendocrine tumors patients may improve their management by better selection of subjects requiring more closed follow-up and more aggressive therapeutic approach.
Aim: To assess factors influencing survival of GEPNET patients livingin Krakow and Krakow district area.
Material and methods: The data from GEPNETs register run in the Endocrinology Department, University Hospital in Krakow, were assessed. 88 patients (49 females and 39 males) aged 59±17 years diagnosed with GEPNETs between January 2007 and December 2011, living in Krakow and Krakow district area,were included in further analysis. 75% of them were followed in the Endocrinology Department, University Hospital in Krakow. Factors influencing 2-year survival were assessed.
Results: The mean follow-up period was 2.7±1.6 years. Two-year survival was 77%. In univariate analysis the following factors were associated with poor prognosis: grade NET G2 (P<0.001), stage III (AJCC/UICC) (P=0.002) or IV (P<0.001) at diagnosis, both nodal and distant metastases at diagnosis (P<0.001), colonic GEPNETs (P=0.039), and management outside specialized GEPNET center (P=0.007). In multivariate standardized models the independent risk factors of poorer prognosis were: higher stage at diagnosis (eight- to tenfold increased risk of death for stages III and IV vs I), metastases at diagnosis (tenfold increased risk of death), the residence outside the limits of Krakow city (three- to fivefold increased risk of death), and the management outside the Department of Endocrinology, University Hospital in Krakow (sevenfold increase in risk of death).
Conclusions: The GEPNET patient survival is influenced not only by the disease extend at diagnosis (staging) and by proliferation indices (grading), but also by area of residency (probably due to mismatch in health care providers availability) and the experience of the center taking care of GEPNET patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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