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Peritoneal Carcinomatosis in Gastro-Entero-Pancreatic Neuroendocrine Neoplasms: Clinical Impact and Effectiveness of the Available Therapeutic Options.
- Source :
-
Neuroendocrinology [Neuroendocrinology] 2020; Vol. 110 (6), pp. 517-524. Date of Electronic Publication: 2019 Sep 05. - Publication Year :
- 2020
-
Abstract
- Background: Peritoneal carcinomatosis (PC) can affect the quality of life of patients with gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs). Peritoneal disease control by medical therapies in these patients has been poorly investigated Objectives: To describe, in a consecutive series of GEP-NENs, the clinical impact of PC and to report the effectiveness of available treatments in PC control.<br />Methods: A retrospective, monocenter analysis was performed of 135 GEP-NENs (1993-2016) with at least a 12-month follow-up. Peritoneal disease progression was defined as detection of a significant increase in size or appearance of new implants by imaging.<br />Results: A total of 62.9% of cases had diffuse PC (involving at least 2 abdominal quadrants). According to WHO 2017 classification, cases were 42.3% neuroendocrine tumors NET-G1, 45.5% NET-G2, 6.5% NET-G3, 4.9% neuroendocrine carcinomas NEC-G3, and 0.8% mixed neuroendocrine-nonneuroendocrine neoplasms. Bowel obstruction occurred in 30 (22.2%) patients mainly depending on size of peritoneal implants (HR: 1.10; 95% CI: 1.02-1.20; p = 0.01). Patients with diffuse PC treated with peptide receptor radionuclide therapy (PRRT) showed peritoneal progression in 37.5% of cases, and bowel obstruction or ascites in 28.1%. Better peritoneal disease control was observed in cases receiving somatostatin analogs at first-line therapy, probably due to a less aggressive disease behavior for these patients.<br />Conclusions: Bowel obstruction is not uncommon in GEP-NENs with PC. PRRT should be adopted with caution in GEP-NENs with diffuse PC, but larger series are needed to confirm these data.<br /> (© 2019 S. Karger AG, Basel.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Disease Progression
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Somatostatin analysis
Digestive System Neoplasms complications
Digestive System Neoplasms drug therapy
Digestive System Neoplasms pathology
Digestive System Neoplasms radiotherapy
Intestinal Obstruction etiology
Intestinal Obstruction pathology
Intestinal Obstruction therapy
Neuroendocrine Tumors complications
Neuroendocrine Tumors drug therapy
Neuroendocrine Tumors pathology
Neuroendocrine Tumors radiotherapy
Outcome Assessment, Health Care
Peritoneal Neoplasms complications
Peritoneal Neoplasms drug therapy
Peritoneal Neoplasms pathology
Peritoneal Neoplasms radiotherapy
Radioisotopes therapeutic use
Receptors, Peptide
Somatostatin therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1423-0194
- Volume :
- 110
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Neuroendocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 31484182
- Full Text :
- https://doi.org/10.1159/000503144