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Purpose: Gastrinoma with Zollinger–Ellison syndrome (ZES) may occur sporadically (Sp) or as part of the inherited syndrome of multiple endocrine neoplasia 1 (MEN-1). Data comparing Sp and MEN-1/ZES are scanty. We aimed to identify and compare their clinical features. Methods: Consecutive patients with ZES were evaluated between 1992 and 2020 among a monocentric Italian patient cohort. Results: Of 76 MEN-1 patients, 41 had gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN), 18 of whom had ZES; of 320 Sp-GEP-NEN, 19 had Sp-ZES. MEN-1/ZES patients were younger (p = 0.035) and the primary MEN-1/ZES gastrinoma was smaller than Sp-ZES (p = 0.030). Liver metastases occurred in both groups, but only Sp-ZES developed extrahepatic metastases. 13 Sp-ZES and 8 MEN-1/ZES underwent surgery. 8 Sp-ZES and 7 MEN-1/ZES received somatostatin analogs (SSAs). Median overall survival (OS) was higher in MEN-1/ZES than in Sp-ZES (310 vs 168 months, p = 0.034). At univariate-logistic regression, age at diagnosis (p = 0.01, OR = 1.1), G3 grading (p = 0.003, OR = 21.3), Sp-ZES (p = 0.02, OR = 0.3) and presence of extrahepatic metastases (p = 0.001, OR = 7.2) showed a significant association with OS. At multivariate-COX-analysis, none of the variables resulted significantly related to OS. At univariate-logistic regression, age (p = 0.04, OR = 1.0), size (p = 0.039, OR = 1.0), G3 grade (p = 0.008, OR = 14.6) and extrahepatic metastases (p = 0.005, OR = 4.6) were independently associated with progression-free survival (PFS). In multivariate-COX-analysis, only extrahepatic metastases (p = 0.05, OR = 3.4) showed a significant association with PFS. Among SSAs-treated patients, MEN-1/ZES showed better PFS (p = 0.0227). After surgery, the median PFS was 126 and 96 months in MEN-1 and Sp, respectively. Conclusion: MEN-1/ZES patients generally show better OS and PFS than Sp-ZES as well as better SSAs response.

In this paper, different machine learning methodologies have been evaluated for the estimation of the multiple soil characteristics of a continental-wide area corresponding to the European region, using multispectral Sentinel-3 satellite imagery and digital elevation model (DEM) derivatives. The results confirm the importance of multispectral imagery in the estimation of soil properties and specifically show that the use of DEM derivatives improves the quality of the estimates, in terms of (Formula presented.), by about 19% on average. In particular, the estimation of soil texture increases by about 43%, and that of cation exchange capacity (CEC) by about 65%. The importance of each input source (multispectral and DEM) in predicting the soil properties using machine learning has been traced back. It has been found that, overall, the use of multispectral features is more important than the use of DEM derivatives with a ration, on average, of 60% versus 40%.