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A cure model survival analysis of patients affected by small intestinal neuroendocrine neoplasms: the Bologna ENETS center experience

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Abstracts

Purpose

The primary end-point was to evaluate the cure fraction. Secondary end-points were to investigate the time to cure, the excess of death risk, the probability of cure and the factors related to these parameters.

Methods

Retrospective study of an ENETS database regarding patients affected by Si-NENs. For each patients, clinical, pathological and follow-up data were collected. The survival analysis was made using a novel approach: the cure model approach.

Results

The cure fraction was 92.1%. The death risk, time to cure and the probability of cure were 6/1000 person-years, 3.6 years and 98.2%, respectively. The independent factors influencing these parameters were the grading and the R status (P = 0.041 and P = 0.017, respectively). Patients affected by Si-NENs G2 increased the death risk and time to cure respect to Si-NENs G1 (51 versus 6 per 1000 person-years and 5.1 versus 3.6 years, respectively) as well as patients not operated respect to those radically resected (R0/1) (66 versus 1 per 1000 person-years and 4.8 versus 0.4 years, respectively). The probability of cure decreased (88.1 versus 97.8% and 80.4 versus 99.7%, respectively). R2 resection shows better results than no resection.

Conclusions

A large portion of patients affected by Si-NENs can be cured. The highest probability of cure regards patients with Si-NENs G1 who underwent to R0/R1 resection; the lower, those with Si-NENs G2 and no resection. R2 resection seems to be preferred respect to no resection.

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References

  1. A. Dasari, C. Shen, D. Halperin, B. Zhao, S. Zhou, Y. Xu, T. Shih, J.C. Yao, Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2017.0589

  2. B. Niederle, U.F. Pape, F. Costa, D. Gross, F. Kelestimur, U. Knigge, K. Öberg, M. Pavel, A. Perren, C. Toumpanakis, J. O’Connor, D. O’Toole, E. Krenning, N. Reed, R. Kianmanesh. Vienna Consensus Conference participants ENETS Consensus Guidelines Update for Neuroendocrine Neoplasms of the Jejunum and Ileum. Neuroendocrinology 103, 125–138 (2016). all other Vienna Consensus Conference participants

    Article  CAS  Google Scholar 

  3. L. Huang, K.A. Cronin, K.A. Johnson, A.B. Mariotto, E.J. Feuer. Improved survival time: what can survival cure models tell us about population-based survival improvements in late-stage colorectal, ovarian, and testicular cancer? Cancer 112, 2289–2300 (2008)

    Article  PubMed  Google Scholar 

  4. M. Cvancarova et al. Proportion cured models applied to 23 cancer sites in Norway. Int J. Cancer 132, 1700–1710 (2013)

    Article  CAS  PubMed  Google Scholar 

  5. C. Ricci, R. Casadei, G. Taffurelli, D. Campana, V. Ambrosini, C.A. Pacilio, D. Santini, N. Brighi, F. Minni. Is radical surgery always curative in pancreatic neuroendocrine tumors? A cure model survival analysis. Pancreatology 18, 313–317 (2018)

    Article  PubMed  Google Scholar 

  6. Italian population life tables. Available at: http://demo.istat.it/. Accessed 25 May 2018

  7. P.C. Lambert, J.R. Thompson, C.L. Weston et al. Estimating and modeling the cure fraction in population-based cancer survival analysis. Biostatistics 8, 576–594 (2007)

    Article  PubMed  Google Scholar 

  8. P.C. Lambert, Modeling of the cure fraction in survival studies. Stata J. 3, 1–25 (2007)

    Google Scholar 

  9. P. Tomassetti, D. Campana, L. Piscitelli, R. Casadei, F. Nori, E. Brocchi, D. Santini, R. Pezzilli, R. Corinaldesi. Endocrine tumors of the ileum: factors correlated with survival. Neuroendocrinology 8, 380–386 (2006)

    Article  CAS  Google Scholar 

  10. L. Wu, J. Fu, L. Wan, J. Pan, S. Lai, J. Zhong, D.C. Chung, L. Wang. Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: a population based retrospective study. Oncotarget 8, 4935–4947 (2017)

    Google Scholar 

  11. I.M. Modlin, K.D. Lye, M. Kidd. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 97, 934–959 (2003)

    Article  PubMed  Google Scholar 

  12. K.Y. Bilimoria, D.J. Bentrem, J.D. Wayne, C.Y. Ko, C.L. Bennett, M.S. Talamonti. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann. Surg. 249, 63–71 (2009)

    Article  PubMed  Google Scholar 

  13. G. Capurso, M. Rinzivillo, R. Bettini, L. Boninsegna, G. Delle Fave, M. Falconi. Systematic review of resection of primary midgut carcinoid tumour in patients with unresectable liver metastases. Br. J. Surg. 99, 1480–1487 (2012)

    Article  CAS  PubMed  Google Scholar 

  14. E.A. Woltering, B.A. Voros, D.T. Beyer, Y.Z. Wang, R. Thiagarajan, P. Ryan, A. Wright, R.A. Ramirez, M.J. Ricks, J.P. Boudreaux. Aggressive Surgical Approach to the Management of Neuroendocrine Tumors: A Report of 1,000 Surgical Cytoreductions by a Single Institution. J. Am. Coll. Surg. 224, 434–447 (2017)

    Article  PubMed  Google Scholar 

  15. E. Bertani, M. Falconi, C. Grana, E. Botteri, A. Chiappa, P. Misitano, F. Spada, D. Ravizza, B. Bazolli, N. Fazio. Small intestinal neuroendocrine tumors with liver metastases and resection of the primary: Prognostic factors for decision making. Int. J. Surg. 20, 58–64 (2015)

    Article  PubMed  Google Scholar 

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Correspondence to Riccardo Casadei.

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Ricci, C., Campana, D., Casadei, C. et al. A cure model survival analysis of patients affected by small intestinal neuroendocrine neoplasms: the Bologna ENETS center experience. Endocrine 64, 702–707 (2019). https://doi.org/10.1007/s12020-019-01870-8

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