title: Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study.
abstract: Neuroendocrine tumors (NET) include a spectrum of malignancies arising from neuroendocrine cells throughout the body. The objective of this clinical investigation of retrospectively and prospectively collected data was to describe the prevalence, demographic data, clinical symptoms and methods of diagnosis of NET and the treatment and long-term follow-up of patients with NET. Data were provided by the participating centers and assessed for consistency by internal reviewers. All the cases were centrally evaluated (when necessary) by the pathologists in our group. The tissue samples were reviewed by hematoxylin and eosin and immunohistochemical staining techniques to confirm the diagnosis of NET. In total, 532 cases were documented: 461 gastroenteropancreatic-NET (GEP-NET) and 71 bronchial NET (BNET). All the tumors were immunohistochemically defined according to the World Health Organization (WHO) and European Neuroendocrine Tumor Society criteria. The most common initial symptoms in GEP-NET were abdominal pain, diarrhea, bowel obstruction, flushing, gastrointestinal bleeding and weight loss. The most common tumor types were carcinoid (58.0%), non-functional pancreatic tumor (23.0%), metastatic NET of unknown primary (16.0%) and functional pancreatic tumor (3.0%). Of the BNET, 89.0% were typical and 11.0% atypical carcinoids. Of the patients with GEP-NET, 59.2% had distant metastasis at diagnosis. The locations of the primary tumors in GEP-NET were the small bowel (26.9%), pancreas (25.2%), colon-rectum (12.4%), appendix (7.6%), stomach (6.9%), esophagus (2.8%), duodenum (2.0%) and unknown primary (16.3%). The histological subtypes based on the WHO classification were well-differentiated NET (20.1%), well-differentiated neuroendocrine carcinomas (66.5%) and poorly differentiated neuroendocrine carcinomas (10.3%). Overall, 67.3% of the patients underwent surgery, 41.2% with curative intent and 26.1% for palliative purposes. The 5-year survival rates were 65.1% (95% confidence interval, 58.0-71.4%) in GEP-NET and 100.0% in typical carcinoid of the lung. This observational, non-interventional, longitudinal study aimed to accumulate relevant information regarding the epidemiology, clinical presentation and current practices in the treatment of NET patients in Argentina, providing insight into regional differences and patterns of care in this heterogeneous disease.
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina ; Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Juan Manuel
authors: JM
authors: O'Connor
authors: SITE, Clinical Oncology, La Plata 1900, Argentina ; Medical Institute Platense, Buenos Aires 1900, Argentina.
authors: Fabiana
authors: F
authors: Marmissolle
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Claudia
authors: C
authors: Bestani
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Veronica
authors: V
authors: Pesce
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Susana
authors: S
authors: Belli
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Enzo
authors: E
authors: Dominichini
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Guillermo
authors: G
authors: Mendez
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Paola
authors: P
authors: Price
authors: SITE, Clinical Oncology, La Plata 1900, Argentina.
authors: Nora
authors: N
authors: Giacomi
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Alejandro
authors: A
authors: Pairola
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Fernando Sánchez
authors: FS
authors: Loria
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Eduardo
authors: E
authors: Huertas
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina ; Department of Clinical Oncology and Thoracic Surgery Unit, Respiratory Rehabilitation Hospital María Ferrer, Buenos Aires C1272AAA, Argentina.
authors: Claudio
authors: C
authors: Martin
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina ; Department of Clinical Oncology and Thoracic Surgery Unit, Respiratory Rehabilitation Hospital María Ferrer, Buenos Aires C1272AAA, Argentina.
authors: Karina
authors: K
authors: Patane
authors: Department of Clinical Oncology and Thoracic Surgery Unit, Respiratory Rehabilitation Hospital María Ferrer, Buenos Aires C1272AAA, Argentina.
authors: Claudia
authors: C
authors: Poleri
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina ; Department of Clinical Oncology and Thoracic Surgery Unit, Respiratory Rehabilitation Hospital María Ferrer, Buenos Aires C1272AAA, Argentina.
authors: Moises
authors: M
authors: Rosenberg
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Ana
authors: A
authors: Cabanne
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Mirta
authors: M
authors: Kujaruk
authors: SITE, Clinical Oncology, La Plata 1900, Argentina ; Hospital El Cruce, Buenos Aires B1888, Argentina.
authors: Analia
authors: A
authors: Caino
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Victor
authors: V
authors: Zamora
authors: Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina.
authors: Javier
authors: J
authors: Mariani
authors: Department of Clinical Oncology, Institute A. Roffo, Buenos Aires C1417AAA, Argentina.
authors: Mariano
authors: M
authors: Dioca
authors: Department of Clinical Oncology, Institute A. Roffo, Buenos Aires C1417AAA, Argentina.
authors: Patricia
authors: P
authors: Parma
authors: Department of Hepatobiliary Pancreatic Disease, Austral University Hospital, Buenos Aires B1629AHJ, Argentina.
authors: Gustavo
authors: G
authors: Podesta
authors: Department of Hepatobiliary Pancreatic Disease, Austral University Hospital, Buenos Aires B1629AHJ, Argentina.
authors: Oscar
authors: O
authors: Andriani
authors: Oncology and Hepatobiliary Pancreatic Units, Favaloro Foundation, Buenos Aires C1093AAS, Argentina.
authors: Gabriel
authors: G
authors: Gondolesi
authors: Oncology Unit, Gastroenterology Hospital Bonorino Udaondo, Buenos Aires C1264AAA, Argentina.
authors: Enrique
authors: E
authors: Roca
keywords: clinical data; multicenter study; neuroendocrine tumors; observational study