title: Persistent low urinary excretion of 5-HIAA is a marker for favourable survival during follow-up in patients with disseminated midgut carcinoid tumours.
abstract: Survival of patients with disseminated midgut carcinoid tumours varies. We investigated which factors predict survival at referral and during follow-up, with emphasis on urinary 5-hydroxyindolacetic acid (5-HIAA) levels. Between 1992 and 2003, 76 patients were studied; urine was prospectively collected over a 24 h period every 3 months in order to measure 5-HIAA levels. Uni- and multivariate analyses were performed. Median follow-up was 55 months with a median survival of 54 months. Prognostic factors for poor survival were high age, high gamma-glutamyltransferase levels and greatly increased 5-HIAA levels (>20 mmol/mol creatinine) The Hazard Ratio (HR) of a greatly increased 5-HIAA level was 3.33 (95% confidence interval (CI) 1.66-6.66, p=0.001). In a multivariate survival analysis with the 5-HIAA level as time dependent covariable, the HR for the 5-HIAA level was 1.007 (95% CI 1.004-1.010, p=0.000). In conclusion, patients with persistent moderately increased urinary 5-HIAA levels (< or =20 mmol/mol creatinine) have favourable outcome.
authors.affiliation: Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. a.n.a.van.der.horst@int.umcg.nl
authors.forename: Anouk N A
authors.initials: AN
authors.lastname: van der Horst-Schrivers
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Post
authors.forename: Ido P
authors.initials: IP
authors.lastname: Kema
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
authors.forename: Pax H B
authors.initials: PH
authors.lastname: Willemse
authors.forename: A N Machteld
authors.initials: AN
authors.lastname: Wymenga
authors.forename: Elisabeth G E
authors.initials: EG
authors.lastname: de Vries
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000652:urine*; D002276:Carcinoid Tumor / Q000401:mortality* / Q000652:urine; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine*; D007414:Intestinal Neoplasms / Q000401:mortality* / Q000652:urine; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012701:Serotonin / Q000097:blood; D016019:Survival Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood