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Pancreastatin Predicts Survival in Neuroendocrine Tumors

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Serum neurokinin A, chromogranin A, serotonin, and pancreastatin reflect tumor burden in neuroendocrine tumors. We sought to determine whether their levels correlate with survival in surgically managed small bowel (SBNETs) and pancreatic neuroendocrine tumors (PNETs).

Methods

Clinical data were collected with Institutional Review Board approval for patients undergoing surgery at one center. Progression-free (PFS) and overall (OS) survival were from the time of surgery. Event times were estimated by the Kaplan–Meier method. Preoperative and postoperative laboratory values were tested for correlation with outcomes. A multivariate Cox model adjusted for confounders.

Results

Included were 98 SBNETs and 78 PNETs. Median follow-up was 3.8 years; 62 % had metastatic disease. SBNETs had lower median PFS than PNETs (2.0 vs. 5.6 years; p < 0.01). Median OS was 10.5 years for PNETs and was not reached for SBNETs. Preoperative neurokinin A did not correlate with PFS or OS. Preoperative serotonin correlated with PFS but not OS. Higher levels of preoperative chromogranin A and pancreastatin showed significant correlation with worse PFS and OS (p < 0.05). After multivariate adjustment for confounders, preoperative and postoperative pancreastatin remained independently predictive of worse PFS and OS (p < 0.05). Whether pancreastatin normalized postoperatively further discriminated outcomes. Median PFS was 1.7 years in patients with elevated preoperative pancreastatin versus 6.5 years in patients with normal levels (p < 0.001).

Conclusions

Higher pancreastatin levels are significantly associated with worse PFS and OS in SBNETs and PNETs. This effect is independent of age, primary tumor site, and presence of nodal or metastatic disease. Pancreastatin provides valuable prognostic information and identifies surgical patients at high risk of recurrence who could benefit most from novel therapies.

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Acknowledgment

We gratefully acknowledge our patients for their participation. Supported by NIH 5T32#CA148062-04 (SKS, JEM)

Disclosure

None of the authors has any potential conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA

    Scott K. Sherman MD, Jessica E. Maxwell MD, MBA & James R. Howe MD

  2. Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA

    M. Sue O’Dorisio MD, PhD

  3. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA

    Thomas M. O’Dorisio MD

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  1. Scott K. Sherman MD
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  2. Jessica E. Maxwell MD, MBA
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  3. M. Sue O’Dorisio MD, PhD
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Corresponding author

Correspondence to James R. Howe MD.

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Sherman, S.K., Maxwell, J.E., O’Dorisio, M.S. et al. Pancreastatin Predicts Survival in Neuroendocrine Tumors. Ann Surg Oncol 21, 2971–2980 (2014). https://doi.org/10.1245/s10434-014-3728-0

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