title: Elevated Plasma Pancreastatin, but Not Chromogranin A, Predicts Survival in Neuroendocrine Tumors of the Duodenum.
abstract: BACKGROUND
  Neuroendocrine tumors (NETs) of the duodenum are rare, heterogeneous, and often indolent neoplasms. We hypothesized that elevated pancreastatin levels are an indicator of a poor prognosis in well-differentiated duodenal NETs.
  
  
  METHODS
  Data from patients diagnosed with a primary duodenal NET were analyzed. Patients that underwent esophogogastroduodenoscopy, endoscopic ultrasound, or exploratory surgery to localize their neoplasm and whose tumors were confirmed histologically were included.
  
  
  RESULTS
  Eighty-four patients were diagnosed with duodenal NETs from January 1991 to January 2014. Seventy-five percent and 21% of patients had their tumor localized by esophogogastroduodenoscopy and endoscopic ultrasound, respectively. The remaining 4% were localized during exploratory surgery. The 5-year Kaplan-Meier survival rate for the entire cohort (N = 84) was 80%. Survival sorted by normal vs abnormal pancreastatin level was statistically significant (p < 0.0001). Five-year survival rates were 94% and 37% for normal and abnormal pancreastatin, respectively. In contrast, survival sorted by normal vs abnormal plasma chromogranin A level was not statistically significant (p = 0.24).
  
  
  CONCLUSIONS
  Patients with primary duodenal NETs have high 5-year survival rates. Serial monitoring of plasma pancreastatin levels can identify patients who have a poor prognosis.
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA. Electronic address: ewolte@lsuhsc.edu.
authors.forename: Eugene A
authors.initials: EA
authors.lastname: Woltering
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: David T
authors.initials: DT
authors.lastname: Beyer
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
authors.forename: Ramcharan
authors.initials: R
authors.lastname: Thiagarajan
authors.affiliation: Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Ramirez
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
authors.forename: Yi-Zarn
authors.initials: YZ
authors.lastname: Wang
authors.affiliation: Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
authors.forename: M Jennifer
authors.initials: MJ
authors.lastname: Ricks
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; Neuroendocrine Tumor Program, Ochsner Medical Center, Kenner, LA.
authors.forename: J Philip
authors.initials: JP
authors.lastname: Boudreaux
mesh_terms: D000368:Aged; D053379:Chromogranin A / Q000378:metabolism*; D004379:Duodenal Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery; D010187:Pancreatic Hormones / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: C506150:CHGA protein, human; D053379:Chromogranin A; D010187:Pancreatic Hormones; C050836:pancreastatin