Risk factors for disease progression in advanced jejunoileal neuroendocrine tumors.
BACKGROUND
Knowledge of clinical course in advanced jejunoileal neuroendocrine tumors (NETs) is poor.


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


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.
Digestive and Liver Disease Unit, 'Sapienza' University of Rome, Rome, Italy.
Francesco
F
Panzuto
Davide
D
Campana
Nicola
N
Fazio
Maria Pia
MP
Brizzi
Letizia
L
Boninsegna
Francesca
F
Nori
Giovanni
G
Di Meglio
Gabriele
G
Capurso
Aldo
A
Scarpa
Luigi
L
Dogliotti
Filippo
F
De Braud
Paola
P
Tomassetti
Gianfranco
G
Delle Fave
Massimo
M
Falconi
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007078:Ileal Neoplasms / Q000401:mortality / Q000628:therapy*; D007580:Jejunal Neoplasms / Q000401:mortality / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D019394:Ki-67 Antigen