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欧洲神经内分泌肿瘤学会登记处,一种评估神经内分泌肿瘤预后的工具。

The European Neuroendocrine Tumour Society registry, a tool to assess the prognosis of neuroendocrine neoplasms.

作者信息

Borbath Ivan, Garcia-Carbonero Rocio, Bikmukhametov Damir, Jimenez-Fonseca Paula, Castaño Angel, Barkmanova Jaroslava, Sedlackova Eva, Kollár Attila, Christ Emanuel, Kaltsas Gregory, Kos-Kudla Beata, Maasberg Sebastian, Verslype Chris, Pape Ulrich-Frank

机构信息

Hepato-gastroenterology Unit, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.

Oncology Department, Hospital Universitario 12 de Octubre, IIS Imas12, UCM, CNIO, CIBERONC, Madrid, Spain.

出版信息

Eur J Cancer. 2022 Jun;168:80-90. doi: 10.1016/j.ejca.2022.03.007. Epub 2022 Apr 23.

Abstract

BACKGROUND

Neuroendocrine neoplasms (NENs) are rare tumours with variable clinical behaviour. Their natural history is ideally best approached in large, multicentre and multinational registries with long-term patients' follow-up. The European Neuroendocrine Tumour Society registry aims to obtain information regarding NEN outcomes and prognostic factors in a European frame.

PATIENTS AND METHODS

We collected data from 7 national NEN registries (Belgium, Czech Republic, Germany, Greece, Poland, Spain, Switzerland), representing 10,102 patients. Anonymised/pseudonymised data were collected in a secured server. Descriptive statistical methods were applied, as well as Kaplan-Meier survival curves and multivariable analyses for prognostic factors of overall survival (OS).

RESULTS

median age of the study population was 60 years (range: 18-102), 48% were female. Common primary tumour sites were pancreas (27%) and small intestine (21%). Stage 4 disease was found in 47% of patients, while 26/10/16% had stage 1/2/3 disease, respectively. Grading (n = 6952) was G1/2/3 in 48/37/15% of the patients, respectively. Surgery was the main treatment, provided to 71% of patients, followed by somatostatin analogues (32%), chemotherapy (20%), Peptide receptor Radionuclide Therapy (PRRT) (9%) and targeted therapies (8%). OS at 5 years was 74%, influenced by grade, stage and tissue of origin in multivariate analysis. A Ki67 cut-off value set at 55% within the G3 group allowed to separate 2 groups with a meaningful different OS.

CONCLUSION

We report the first analysis of the European Neuroendocrine Tumour Society registry, comprising 10,102 patients with NEN from 7 European countries. This large cohort study describes prognostic factors for the survival of NENs throughout Europe, including primary tumour site, grade, stage and treatment.

摘要

背景

神经内分泌肿瘤(NENs)是临床行为各异的罕见肿瘤。其自然病程最好在大型、多中心和跨国登记处对患者进行长期随访的情况下进行研究。欧洲神经内分泌肿瘤学会登记处旨在获取欧洲范围内有关NENs结局和预后因素的信息。

患者与方法

我们收集了来自7个国家NEN登记处(比利时、捷克共和国、德国、希腊、波兰、西班牙、瑞士)的10102例患者的数据。匿名/化名数据收集于安全服务器中。应用了描述性统计方法,以及Kaplan-Meier生存曲线和总生存(OS)预后因素的多变量分析。

结果

研究人群的中位年龄为60岁(范围:18 - 102岁),48%为女性。常见的原发肿瘤部位是胰腺(27%)和小肠(21%)。47%的患者为4期疾病,而26/10/16%的患者分别为1/2/3期疾病。分级(n = 6952)的患者中,G1/G2/G3分别占48/37/15%。手术是主要治疗方式,71%的患者接受了手术,其次是生长抑素类似物(32%)、化疗(20%)、肽受体放射性核素治疗(PRRT)(9%)和靶向治疗(8%)。5年总生存率为74%,多变量分析显示其受分级、分期和起源组织的影响。在G3组中,将Ki67临界值设定为55%可将患者分为两组,其总生存率有显著差异。

结论

我们报告了对欧洲神经内分泌肿瘤学会登记处的首次分析,该登记处包含来自7个欧洲国家的10102例NEN患者。这项大型队列研究描述了整个欧洲NENs生存的预后因素,包括原发肿瘤部位、分级、分期和治疗。

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