Peritoneal Metastases from Gastroenteropancreatic Neuroendocrine Tumors: Incidence, Risk Factors and Prognosis

Ariana Madani*, Irene Thomassen, Yvette R. B. M. van Gestel, Jarmila D. W. van der Bilt, Harm R. Haak, Ignace H. J. T. de Hingh, Valery E. P. P. Lemmens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

Background. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare neoplasms and data on peritoneal metastases (PM) from these tumors are scarce.

Objective. The aim of this study was to present population-based data on the incidence, risk factors, and survival of synchronous PM in GEP-NETs.

Methods. Data from all patients diagnosed with a GEP-NET during 2007-2013 were collected from the Netherlands Cancer Registry. Age-standardized incidence rates were calculated and risk factors for developing PM were determined using multivariable logistic regression analysis. Survival was investigated using Kaplan-Meier and Cox regression analyses.

Results. A total of 4114 patients were diagnosed with a GEP-NET. PM were diagnosed in 234 patients (19% of patients with metastasized disease, representing 6% of all GEP-NETs). The incidence of patients diagnosed with PM was 1.6:1,000,000 persons per year. Risk factors for developing PM were higher age (odds ratio [OR] 1.4, 95% CI 1.0-2.0) and primary tumor location in the small intestine (OR 3.5, 95% CI 2.1-5.7) or colon (OR 2.5, 95% CI 1.4-4.4). Small intestinal NETs with PM had the best survival, while appendiceal NETs with PM had the poorest survival (5-year survival rates of 67 and 7%, respectively). Multivariate analysis showed that survival in patients with PM was worse compared with patients without metastases; however, the presence of PM among all metastasized patients was not associated with worse survival.

Conclusions. This nationwide population-based study provides relevant insight into the incidence and risk factors of PM in GEP-NETs, and reveals detailed site-specific data on the presence of PM and survival data that may contribute to develop individualized treatment strategies in patients with these heterogeneous neoplasms.

Original languageEnglish
Pages (from-to)2199-2205
Number of pages7
JournalAnnals of Surgical Oncology
Volume24
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY
  • DIGESTIVE ENDOCRINE TUMORS
  • CARCINOID-TUMORS
  • SURGICAL-TREATMENT
  • COLORECTAL-CANCER
  • LIVER METASTASES
  • CARCINOMATOSIS
  • SURVIVAL
  • POPULATION
  • NETHERLANDS

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