Clinical profile and treatment outcomes of metastatic neuroendocrine carcinoma: A single institution experience

Lokesh, K N; Anand, AS; Lakshmaiah, K C; Babu, K Govind; Dasappa, Lokanatha; Jacob, Linu Abraham; Babu, MC Suresh; Rudresha, A H; Rajeev, L K; Smitha, S.; Giri, GV; Panwar, Dipti; Koppaka, Deepak; Patidar, Rajesh

doi:10.4103/sajc.sajc_176_17

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…Broecker, based on a single-institution experience of over 15 years, found that colonic NETs have more aggressive clinicopathologic features and worse outcomes compared with rectal NETs [12]. The metastasis in our case was similar to that reported in most studies, but Lokesh reported a higher rate (54%) of bone metastasis [11].…”

Section: Discussionsupporting

confidence: 79%

“…Colorectal NECs are highly malignant neoplasms. Compared to metastatic extrapulmonary NECs, metastatic pulmonary NECs have a worse outcome [3,4,11].…”

Section: Discussionmentioning

confidence: 99%

“…Grade 3 NEC has a mitotic count of more than 20 per 10 HPFs and/or a Ki67 index of more than 20%. Multiple studies have demonstrated a very strong association between Ki67 level (equal to or more than 55% vs. less than 55%) and the survival in patients with NEC [11,15].…”

Section: Discussionmentioning

confidence: 99%

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A Perforated Colonic Neuroendocrine Tumor with Liver Metastasis: A Case Report and Literature Review

et al. 2019

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Patient: Male, 57 Final Diagnosis: High grade and invasive colonic neuroendocrine carcinoma Symptoms: Abdomen distension Medication: — Clinical Procedure: Subtotal colectomy and ileostomy creation Specialty: Surgery Objective: Unusual clinical course Background: Neuroendocrine neoplasms (NENs) originate from cells of the endocrine and nervous systems, and they are rarely encountered in colorectal cases with no specific symptoms. The incidence and prevalence of NENs of the large bowel are increasing. Malignant colonic types are known to have poor diagnosis. The mean age of colonic NENs is the seventh decade, and the risk of NENs is increased 4-fold with affected first-degree family members. Case Report: A 57-year-old male patient presented to our Emergency Department with a 5-day history of severe generalized abdominal pain associated with worsening abdominal distension, history of night sweats, and weight loss. A CT scan of the abdomen and pelvis demonstrated a large heterogeneously enhancing neoplastic mass lesion involving the splenic flexure of the colon surrounded by fat stranding with a small contained leak, in addition to multiple metastatic hypodense focal hepatic lesions. Multiple lymph nodes under 1 cm in size were also noted. The patient underwent exploratory laparotomy, subtotal colectomy, ileostomy creation, and washout. The histopathological exam revealed high-grade invasive colonic neuroendocrine carcinoma, which was pT4N2bM1c, while the peritoneal lesion was metastatic carcinoma. The patient was then referred to the multidisciplinary tumor board. Conclusions: Unusual presentation of neuroendocrine tumors is shown to be expected. Since colorectal NECs are rare, highly aggressive diseases and usually discovered very late, individualization of management, as well as additional research, is required.

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Section: Discussionsupporting

confidence: 79%

“…Colorectal NECs are highly malignant neoplasms. Compared to metastatic extrapulmonary NECs, metastatic pulmonary NECs have a worse outcome [3,4,11].…”

Section: Discussionmentioning

confidence: 99%

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A Perforated Colonic Neuroendocrine Tumor with Liver Metastasis: A Case Report and Literature Review

et al. 2019

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“…According to statistics from the US SEER database, the median OS of advanced intra-pulmonary NECs is 5.8 months, the median OS of extra-pulmonary NECs in the gastrointestinal tract is 5.2 months, the median OS of extra-pulmonary NECs in other regions is 7.5 months, and the median OS of extra-pulmonary NECs in other regions is longer than that of intrapulmonary NECs [5] . In addition, a study by Lokesh et al showed that the median OS of extra-pulmonary NECs was longer than that of intra-pulmonary NECs (13 months vs. 8 months) [40] . In our study, however, the median OS of intra-pulmonary NECs (13.53 months) was signi cantly longer than that of extrapulmonary NECs in the gastrointestinal tract (9.42 months) and extra-pulmonary NECs in the other regions (8.69 months).…”

Section: Results Of Multivariate Analysis Affecting Prognosismentioning

confidence: 99%

Clinical Features And Prognosis of Advanced Intra- And Extra-Pulmonary Neuroendocrine Carcinomas

Chen

Guo

Yang

et al. 2021

Preprint

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Objective: We analyzed the clinical features and prognosis of advanced intra- and extra-pulmonary neuroendocrine carcinomas (NECs) in order to provide further guidance for the clinical treatment of small-cell lung cancer, which is a type of advanced intrapulmonary NECs. Methods: The clinical data and survival of 123 patients with advanced intra- and extra-pulmonary NECs in the Fujian Medical University Union Hospital, Fujian Province, China, between January 2013 to November 2019 were collected. We retrospectively analyzed the corresponding clinical diagnosis and treatment, and explored the relevant factors affecting the survival prognosis of patients with intra- and extra-pulmonary NECs. Results: The data of 123 patients were collected. There were 90 cases of intra-pulmonary NECS (including 81 cases of small-cell lung cancer, SCLC), 25 cases of extra-pulmonary NECs involving in the gastrointestinal tract, and 8 cases of extra-pulmonary NECs in other regions. The median overall survival (OS) of intra-pulmonary NECs was 13.53 months, of which the median OS of SCLC was 12.97 months, and the median OS of other intra-pulmonary NECs was 27.07 months. The median OS of extra-pulmonary NECs in the gastrointestinal tract was 9.42 months, and the OS of extra-pulmonary NECs in the other regions was 8.69 months. The median OS of intra-pulmonary NECs was significantly longer than that of the extra-pulmonary NECs in the gastrointestinal tract and in the other regions (P < 0.05). Multivariate analysis showed that age, liver metastasis, number of cycles of first-line chemotherapy, and chest radiotherapy were risk factors affecting OS in patients with NECs (P < 0.05). Conclusions: The survival of intra-pulmonary NECs was significantly longer than that of extra-pulmonary NECs of the gastrointestinal tract and in other regions. However, patients with advanced intra- and extra-pulmonary NECs who were older and had liver metastases had a poorer prognosis. Multi-disciplinary treatments such as multi-cycle chemotherapy and combination of chemotherapy and radiotherapy should play an important role in prolonging the survival of NECs.

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“…Nevertheless, the patient response is generally unsatisfactory for current chemotherapy or targeted therapy, and particularly, the response rate usually is less than 10% after the front-line therapy (6). Furthermore, recommended agents for many rare tumors are usually very limited from guidelines and are not improved for many years (7)(8)(9)(10); and personalized medicine is strongly demanded in those circumstances. Therefore, a robust drug screening system that can quickly identify efficacious drugs will significantly impact either ICIs combination therapy and standard cancer care (11,12).…”

Section: Introductionmentioning

confidence: 99%

A fast and efficient model for real-time anti-tumor drug efficacy test in the clinical setting based on patient-derived tumor xenograft

Zhu¹,

Wang²,

Wang³

et al. 2021

Preprint

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Drug response rates in cancer therapies are frequently unsatisfactory (first-line 30-40%, subsequent-line ~10% or less). The mouse model, patient-derived tumor xenograft (PDTX), can help promote drug effective rate to over 80% by precisely electing efficacious agents. However, the low engraftment rates, extended testing cycle, and high cost limit its utilization in the clinical setting. A novel method, FastPDTX, was developed, in which a substitutive engrafting procedure was applied, and the labor-intensive and time-consuming propagation of tumorgrafts was circumvented by pathological analysis. A comprehensive evaluation involving tumor biology and clinical performance was performed for this new model. The clinical evaluation engaged 431 PDTX cases, 1050 FastPDTX cases, 531 therapeutic entities, 6535 regimens, and a broad spectrum of solid tumors. Typical cases were also studied, covering various refractory malignant tumors. FastPDTX kept biological architectures and genetic characteristics of the primary tumor and displayed an equivalent positive predictive value as PDTX for the drug efficacy test. The testing cycle was reduced from 3-6 months to 3 weeks, and the cost was decreased by 85%. More importantly, the obstacle of low engraftment rate was circumvented, resulting in the percentage of appliable tests nearly 5-fold higher (94.8% vs. 16.7%) than PDTX. FastPDTX is particularly suitable in circumstances where standard care is not available and the therapeutic window is short, and for cases where tumors have indolent growth in mice. FastPDTX preserved the advantages of classical PDTX, overcame its major limitations, and showed great potential for real-time clinic drug selection in cancer therapy.

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Clinical profile and treatment outcomes of metastatic neuroendocrine carcinoma: A single institution experience

Cited by 9 publications

References 27 publications

A Perforated Colonic Neuroendocrine Tumor with Liver Metastasis: A Case Report and Literature Review

A Perforated Colonic Neuroendocrine Tumor with Liver Metastasis: A Case Report and Literature Review

Clinical Features And Prognosis of Advanced Intra- And Extra-Pulmonary Neuroendocrine Carcinomas

A fast and efficient model for real-time anti-tumor drug efficacy test in the clinical setting based on patient-derived tumor xenograft

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