Is Multifocality an Indicator of Aggressive Behavior in Small Bowel Neuroendocrine Tumors?

Allen B Choi; Jessica E Maxwell; Kendall J Keck; Andrew J Bellizzi; Joseph S Dillon; Thomas M OʼDorisio; James R Howe

doi:10.1097/MPA.0000000000000911

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Is Multifocality an Indicator of Aggressive Behavior in Small Bowel Neuroendocrine Tumors?

Journal article

Peer reviewed

Is Multifocality an Indicator of Aggressive Behavior in Small Bowel Neuroendocrine Tumors?

Allen B Choi, Jessica E Maxwell, Kendall J Keck, Andrew J Bellizzi, Joseph S Dillon, Thomas M OʼDorisio and James R Howe

Pancreas, Vol.46(9), pp.1115-1120

10/2017

DOI: 10.1097/MPA.0000000000000911

PMCID: PMC5679126

PMID: 28902780

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https://www.ncbi.nlm.nih.gov/pmc/articles/5679126View

Open Access

Abstract

Many patients with small bowel neuroendocrine tumors (SBNETs) have multifocal tumors (MFTs), but the frequency of MFTs has varied widely across SBNET studies. It is also unclear whether patients with MFTs have more advanced disease or worse clinical course than do those with unifocal SBNETs. We set out to determine the frequency of multifocal and unifocal SBNETs and compare clinicopathologic factors, somatostatin receptor 2 expression, and survival. Clinicopathologic variables from 179 patients with surgically managed SBNETs were collected. Statistical comparisons were made using Welch t-test, Wilcoxon test, and Fisher's exact test. Survival was assessed using the Kaplan-Meier method. Somatostatin receptor 2 expression was analyzed by quantitative polymerase chain reaction, and Ki-67 expression by immunohistochemistry. Multifocal tumors were found in 45% of patients with SBNETs. Clinicopathologic factors such as grade, TNM stage, presence of distant metastases, mean somatostatin receptor 2 expression, success of imaging modalities, and preoperative and postoperative hormone levels were not significantly different between multifocal and unifocal groups. Progression-free survival and overall survival were also not significantly affected by multifocality. Clinicopathologic features and survival of patients with MFTs and unifocal tumors are remarkably similar. Although the etiology of MFTs is unclear, patients with MFTs do not have a more aggressive clinical course than patients with unifocal SBNETs.

Neuroendocrine Tumors - pathology

Intestine, Small - pathology

Neuroendocrine Tumors - metabolism

Humans

Intestinal Neoplasms - metabolism

Middle Aged

Gene Expression Regulation, Neoplastic

Kaplan-Meier Estimate

Male

Intestinal Neoplasms - pathology

Neuroendocrine Tumors - genetics

Receptors, Somatostatin - genetics

Young Adult

Adolescent

Aged, 80 and over

Adult

Female

Ki-67 Antigen - biosynthesis

Aged

Intestine, Small - metabolism

Intestinal Neoplasms - genetics

Details

Title: Subtitle: Is Multifocality an Indicator of Aggressive Behavior in Small Bowel Neuroendocrine Tumors?
Creators: Allen B Choi - From the Departments of General Surgery, †Pathology, and ‡Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Jessica E Maxwell
Kendall J Keck
Andrew J Bellizzi
Joseph S Dillon
Thomas M OʼDorisio
James R Howe
Resource Type: Journal article
Publication Details: Pancreas, Vol.46(9), pp.1115-1120
DOI: 10.1097/MPA.0000000000000911
PMID: 28902780
PMCID: PMC5679126
NLM abbreviation: Pancreas
ISSN: 0885-3177
eISSN: 1536-4828
Publisher: United States
Grant note: T32 CA148062 / NCI NIH HHS T35 HL007485 / NHLBI NIH HHS P30 CA086862 / NCI NIH HHS P50 CA174521 / NCI NIH HHS
Language: English
Date published: 10/2017
Academic Unit: Pathology; Surgery; Fraternal Order of Eagles Diabetes Research Center; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984051567102771

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