1. [Management of treatment in patients with neuroendocrine neoplasmas of digestive tract].
- Author
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Kinová S, Kovácová M, Caprnda M, and Koren M
- Subjects
- Adult, Chromogranin A blood, Female, Gastrointestinal Neoplasms blood, Gastrointestinal Neoplasms pathology, Humans, Hydroxyindoleacetic Acid blood, Intestine, Small pathology, Male, Middle Aged, Neuroendocrine Tumors blood, Neuroendocrine Tumors pathology, Prognosis, Antineoplastic Agents therapeutic use, Biomarkers, Tumor blood, Endoscopy, Digestive System, Gastrointestinal Neoplasms therapy, Interferons therapeutic use, Intestine, Small surgery, Liver Neoplasms secondary, Neuroendocrine Tumors therapy, Radiotherapy methods
- Abstract
Neuroendocrine neoplasmas are a form of cancer arising from cells of diffuse neuroendocrine system. They produce peptides or amines that act as hormones or neurotransmitters. Incidence of NENs is relatively low. Diagnostic work-up and treatment requires a multidisciplinary team approach. The aim of this study was an analysis of data from patients with well-differentiated neuroendocrine neoplasmas of gastrointestinal tract. The study included patients followed up from 1998 to 2013 with histologically confirmed well-differentiated digestive neuroendocrine neoplasm with low or intermediate malignant potential. 97 patients were included; 34 men (35.1%) and 63 women (64.9%). In patients being diagnosed after 2005 interferon treatment is significantly less used than endoscopic and peptide receptor radionuclide therapy. We have identified more appropriate discriminant values of 5-HIAA and chromogranin A (6.8 mg/24 hours; 70 ng/ml) for predicting the presence of metastases at the time of diagnosis. We have identified following risk factors for overall mortality: liver metastases, presence of diarrhea, flush, small bowel primary tumor, high values of CgA and 5-HIAA at the time of diagnosis (5-HIAA > 520.52 mg/24 hours, CgA > 174.5 ng/ml). Surgical treatment was found to be a positive prognostic factor.
- Published
- 2015