Kulkarni Rahul Suhas, Anand Asha S, Parikh Sonia K, Panchal Harsha P, Patel Apurva A, Mehta Dhruv P, Patel Priyanka
Department of Medical and Pediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.
South Asian J Cancer. 2019 Jul-Sep;8(3):198-202. doi: 10.4103/sajc.sajc_364_18.
Most of the data on neuroendocrine tumors (NETs) are from the Western literature. Indian studies regarding clinicopathological characteristics and treatment outcomes are lacking.
This is a prospective observational study of all new patients with NETs (except small-cell lung cancer) registered at our tertiary care cancer institute from November 2014 to November 2016. A total of 97 new patients were registered, of which 20 were lost to follow-up before starting any planned treatment. Epidemiological and clinicopathological features of all these 97 patients were studied, and the remaining 77 patients were analyzed for treatment response and survival analysis.
The median age at diagnosis was 49 years (20-74 years) with male preponderance (M: F = 1.85:1). The most common primary site of origin was pancreas (34/97 = 35%), followed by unknown primary origin (19%), small intestine (9%), and pulmonary (6%). Of 97 patients, 91 (93.8%) presented with nonfunctional symptoms, 3 (3.1%) had purely functional symptoms, and 3 (3.1%) presented with both functional and nonfunctional symptoms. The most common presenting symptom was abdominal pain (59.7%), followed by jaundice (9.3%), whereas watery diarrhea (83.3%) and flushing (66.7%) were the most common functional symptoms. Sixty-six percent (64/97) of cases were metastatic at presentation. A strong correlation was noted between the primary site of origin and metastatic presentation ( = 0.016). Chemotherapy was the most common primary therapy (40.2%), followed by surgery (28.6%), watchful waiting (15.6%), and somatostatin analogs (11.7%). The median event-free survival was highest for patients undergoing surgery (10 months).
The clinicopathological profile of NETs in the Indian population differs from Western countries. Majority of patients present with metastatic disease, thus representing a need for creating awareness among patients and medical fraternity and formulating Indian guidelines for optimized treatment.
大多数关于神经内分泌肿瘤（NETs）的数据来自西方文献。缺乏印度关于神经内分泌肿瘤临床病理特征及治疗结果的研究。
这是一项对2014年11月至2016年11月在我们三级癌症护理研究所登记的所有新诊断的神经内分泌肿瘤患者（小细胞肺癌除外）进行的前瞻性观察研究。共登记了97例新患者，其中20例在开始任何计划治疗前失访。研究了这97例患者的流行病学和临床病理特征，并对其余77例患者进行了治疗反应分析和生存分析。
诊断时的中位年龄为49岁（20 - 74岁），男性占优势（男：女 = 1.85：1）。最常见的原发部位是胰腺（34/97 = 35%），其次是原发部位不明（19%）、小肠（9%）和肺部（6%）。97例患者中，91例（93.8%）表现为无功能症状，3例（3.1%）有单纯功能性症状，3例（3.1%）既有功能性症状又有无功能症状。最常见的症状是腹痛（59.7%），其次是黄疸（9.3%），而水样腹泻（83.3%）和潮红（66.7%）是最常见的功能性症状。66%（64/97）的病例在就诊时已发生转移。原发部位与转移表现之间存在强相关性（ = 0.016）。化疗是最常见的主要治疗方法（40.2%），其次是手术（28.6%）、观察等待（15.6%）和生长抑素类似物（11.7%）。接受手术的患者无事件生存期中位数最高（10个月）。
印度人群中神经内分泌肿瘤的临床病理特征与西方国家不同。大多数患者就诊时已发生转移，因此需要提高患者和医学界的认识，并制定印度优化治疗指南。
