Risk factors for disease progression in advanced jejunoileal neuroendocrine tumors

Neuroendocrinology. 2012;96(1):32-40. doi: 10.1159/000334038. Epub 2011 Dec 28.

Abstract

Background: Knowledge of clinical course in advanced jejunoileal neuroendocrine tumors (NETs) is poor.

Aim: To investigate progression-free survival (PFS), overall survival (OS), and possible predictors for disease progression (DP) in advanced jejunoileal NETs.

Patients and methods: We carried out a multicenter, retrospective analysis of incoming patients with sporadic advanced jejunoileal NETs. PFS and OS were assessed by Kaplan-Meier analysis. Risk factors for progression were analyzed by the Cox proportional hazards method.

Results: Of the 114 patients enrolled, 46.5% had functioning tumors, 93.9% had stage IV disease, and 57.3 and 42.7% were G1 and G2 tumors, respectively. During a median follow-up of 48 months (interquartile range 29-84 months), DP occurred in 61.4% of patients, after 19 months (interquartile range 10-41 months) from diagnosis. Median PFS was 36 months. The 2-year and 5-year PFS were 59 and 33%, respectively, while 5-year OS was 77.5%. Ki67 was the sole strong independent risk factor for unfavorable outcome according to multivariate analysis, being significantly associated with both PFS and OS.

Conclusions: DP occurred in the majority of patients with advanced jejunoileal NETs, with median PFS being 36 months. Ki67 was a significant predictor of DP and should be considered in determining appropriate treatments and planning follow-up for these patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Ileal Neoplasms / mortality
  • Ileal Neoplasms / therapy*
  • Jejunal Neoplasms / mortality
  • Jejunal Neoplasms / therapy*
  • Kaplan-Meier Estimate
  • Ki-67 Antigen / metabolism*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / therapy*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Ki-67 Antigen