7201 Carcinoids: Increasing Incidence Overall and Disproportionate Mortality in the Elderly

Pérez, Eduardo A.; Koniaris, Leonidas G.; Snell, Sarah E.; Gutierrez, Juan C.; Sumner, William E.; Lee, Dong Hoon; Hodgson, Nicole; Livingstone, Alan S.; Franceschi, Dido

doi:10.1007/s00268-005-0774-6

Cited by 65 publications

(48 citation statements)

References 22 publications

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“…Although quite rare compared with other carcinomas and comprising o1% of all cancers, the prevalence of well-differentiated neuroendocrine tumors has increased over the last few decades. 2,21,23,25 Although some well-differentiated neuroendocrine tumors secrete peptides and neuroamines leading to distinct clinical syndromes and early detection, many welldifferentiated neuroendocrine tumors are clinically silent until late presentation as metastatic disease, particularly hepatic metastases, with an unknown primary site of origin at presentation. 2,6 At present, conventional imaging modalities are unable to accurately identify the primary site of tumor in 20-50% of cases.…”

Section: Discussionmentioning

confidence: 99%

PAX8 expression reliably distinguishes pancreatic well-differentiated neuroendocrine tumors from ileal and pulmonary well-differentiated neuroendocrine tumors and pancreatic acinar cell carcinoma

et al. 2011

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PAX (paired box) genes encode a family of transcription factors that regulate organogenesis in a variety of organs. Very little is known about the role of PAX8 in endocrine cell development and the expression of PAX8 in neuroendocrine tumors. The purpose of this study was to analyze PAX8 immunohistochemical expression in gastroenteropancreatic and pulmonary well-differentiated neuroendocrine tumors to determine whether PAX8 can reliably distinguish pancreatic neuroendocrine tumors from neuroendocrine tumors of other anatomic sites and other pancreatic non-ductal neoplasms. In total, 221 well-differentiated neuroendocrine tumors were evaluated: 174 primary neuroendocrine tumors (66 pancreatic, 31 ileal, 21 pulmonary, 20 gastric, 17 rectal, 11 appendiceal, and 8 duodenal) and 47 neuroendocrine tumors metastatic to the liver (31 pancreatic, 11 ileal, 2 pulmonary, 2 duodenal, and 1 rectal). Fifteen solid-pseudopapillary neoplasms and six acinar cell carcinomas of the pancreas were also evaluated. PAX8 was positive in 49/66 (74%) primary pancreatic neuroendocrine tumors. PAX8 expression did not correlate with World Health Organization categorization, grade, size, functional status, or the presence of liver or lymph node metastasis. PAX8 expression was identified in 0/31 (0%) ileal, 0/21 (0%) pulmonary, 2/20 (10%) gastric, 5/17 (29%) rectal, 1/11 (9%) appendiceal, and 6/8 (75%) duodenal neuroendocrine tumors. PAX8 was positive in 4/15 (27%) solid-pseudopapillary neoplasms of the pancreas, whereas all acinar cell carcinomas (0/6) lacked immunoreactivity. Among liver metastases, only pancreatic neuroendocrine tumors (20/31, 65%) were PAX8 positive, whereas no cases of ileal (0/11), pulmonary (0/2), duodenal (0/2), and rectal (0/1) neuroendocrine tumor metastases were PAX8 positive. PAX8 is expressed in primary and metastatic pancreatic well-differentiated neuroendocrine tumors, and its expression can reliably distinguish pancreatic from ileal and pulmonary well-differentiated neuroendocrine tumors. Duodenal neuroendocrine tumors and a subset of rectal, gastric, and appendiceal neuroendocrine tumors may also express PAX8. PAX8 expression can distinguish pancreatic neuroendocrine tumors from acinar cell carcinomas, but its utility in distinguishing neuroendocrine tumors from solid-pseudopapillary neoplasms is limited.

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Section: Discussionmentioning

confidence: 99%

PAX8 expression reliably distinguishes pancreatic well-differentiated neuroendocrine tumors from ileal and pulmonary well-differentiated neuroendocrine tumors and pancreatic acinar cell carcinoma

et al. 2011

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“…The data collected from large cancer registries provides insight into tumor behavior and allow us to examine outcomes from current treatment strategies. [13][14][15][16][17][18] Although this represents an excellent database for comparative outcomes analysis, it is not without limitations. Using area poverty as a proxy for SES may result in misclassification of some patients whose postal code does not accurately reflect the true income level of the individual.…”

Section: Discussionmentioning

confidence: 99%

African American and poor patients have a dramatically worse prognosis for head and neck cancer

Molina

Cheung

Pérez

et al. 2008

Cancer

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190

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BACKGROUND.Differences in cancer survival based on race, ethnicity, and socioeconomic status (SES) are a major issue. To identify points of intervention and improve survival, the authors sought to determine the impact of race, ethnicity, and socioeconomic status for patients with cancers of the head and neck (HN).METHODS.HN cancer patients diagnosed between 1998 and 2002 were examined using a linked Florida Cancer Data System and Florida Agency for Health Care Administration data set.RESULTS.A total of 20,915 patients with HN cancers were identified, predominantly in the oral cavity and larynx. Overall, 72% of patients were male, 89.7% were white, 8.4% were African American (AA), and 10.6% were Hispanic. The median survival time (MST) was 37 months. MST varied significantly by race (white, 40 months vs AA, 21 months; P < .001), sex (men, 36 months vs women, 41 months; P = .001), and area poverty level (lowest, 27 months vs highest, 34 months; P < .0001). Only 32% of AA patients underwent surgery in comparison with 45% of white patients (P < .001). On multivariate analysis, independent predictors of poorer outcomes were race, poverty, age, sex, tumor site, stage, grade, treatment modality, and a history of smoking and alcohol consumption.CONCLUSIONS.Carcinomas of the HN have an overall high mortality with a disproportionate impact on AA patients and the poor. Dramatic disparities by race and SES are not explained completely by demographics, comorbid conditions, or undertreatment. Earlier diagnosis and greater access to surgery and adjuvant therapies in these patients would likely yield significant improvement in outcomes. Cancer 2008. © 2008 American Cancer Society.

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“…Prognosis for small intestinal NEN is thus considerably better than for other small intestinal neoplasms such as lymphomas, adenocarcinomas, and sarcomas [14] . In the older patient group of more than 60 years at initial diagnosis, the outcome figures may be worse as was suggested by analysis of the population-based Florida Cancer Data System (FCDS) [22] , but this may not be exclusively related to NEN but rather other secondary neoplasms or other age-related causes of death [16] .…”

Section: Jejuno-ileal Neuroendocrine Neoplasmsmentioning

confidence: 99%

ENETS Consensus Guidelines for the Management of Patients with Neuroendocrine Neoplasms from the Jejuno-Ileum and the Appendix Including Goblet Cell Carcinomas

et al. 2012

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7201 Carcinoids: Increasing Incidence Overall and Disproportionate Mortality in the Elderly

Abstract: The incidence of pulmonary and gastrointestinal carcinoids has dramatically increased since 1981. Tumor location and age > or = 60 years are the strongest predictors of mortality.

Cited by 65 publications

References 22 publications

PAX8 expression reliably distinguishes pancreatic well-differentiated neuroendocrine tumors from ileal and pulmonary well-differentiated neuroendocrine tumors and pancreatic acinar cell carcinoma

PAX8 expression reliably distinguishes pancreatic well-differentiated neuroendocrine tumors from ileal and pulmonary well-differentiated neuroendocrine tumors and pancreatic acinar cell carcinoma

African American and poor patients have a dramatically worse prognosis for head and neck cancer

ENETS Consensus Guidelines for the Management of Patients with Neuroendocrine Neoplasms from the Jejuno-Ileum and the Appendix Including Goblet Cell Carcinomas

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