Incidental diagnosis of pancreatic neuroendocrine tumors.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 190-190
Author(s):  
A. Cheema ◽  
L. K. Kvols ◽  
J. R. Strosberg
Keyword(s):  
Neuroendocrine Tumors ◽  
Early Stage ◽  
Hormone Secretion ◽  
Survival Rates ◽  
Stage Iv ◽  
Stage I ◽  
Cancer Center ◽  
Pancreatic Neuroendocrine Tumors ◽  
7Th Edition ◽  
Symptomatic Diagnosis

190 Background: Pancreatic neuroendocrine tumors are often discovered incidentally during radiologic or endoscopic examinations. The incidence of incidental detection is unknown. It is also unclear whether patients with incidentally discovered, asymptomatic tumors should be treated similarly to patients who present with tumor-related symptoms. Methods: A database of 425 patients with pancreatic neuroendocrine tumors treated at the H. Lee Moffitt Cancer Center was developed. Patient charts were reviewed to assess whether their diagnosis was incidental or prompted by tumor-related symptoms such as pain, jaundice, or neuroendocrine hormone secretion. The frequency of “incidentalomas” was categorized by TNM stage (AJCC, 7th edition). Overall survival was stratified by “incidental” versus “symptomatic” diagnosis. Results: Among 425 patients with histologically proven pancreatic neuroendocrine tumors, 112 patients (26%) had tumors that were discovered incidentally. The majority of stage I tumors (55%) were incidentally discovered. Among patients with stage IV tumors, 20% were detected incidentally (Table). Median survival of patients with incidentally discovered tumors was 103 months versus 84 months in patients who were symptomatic at diagnosis. Conclusions: A sizeable fraction of patients with pancreatic neuroendocrine tumors are diagnosed incidentally during evaluations for other conditions or unrelated symptoms. The majority of patients with stage I tumors are incidentally diagnosed. The increased incidence of pancreatic neuroendocrine “incidentaloms” may be contributing to improving survival rates in this disease. This study highlights the necessity of developing guidelines for management of patients with incidentally discovered, early-stage tumors. [Table: see text] No significant financial relationships to disclose.

Treatment Outcomes in Completely Resected Stage I to Stage IV Uterine Carcinosarcoma With Rhabdomyosarcoma Differentiation

2013 ◽  
Vol 23 (9) ◽  
pp. 1635-1641 ◽  
Author(s):  
Vicky Makker ◽  
Sara J. Kravetz ◽  
Jacqueline Gallagher ◽  
Oana-Paula Orodel ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Group Versus ◽  
Stage Iv ◽  
Stage I ◽  
Cancer Center ◽  
Uterine Carcinosarcoma ◽  
Entire Cohort ◽  
Gynecology And Obstetrics ◽  
Resected Stage

ObjectiveTo evaluate overall survival (OS) and progression-free survival (PFS) after adjuvant therapy in stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation.MethodsMemorial Sloan-Kettering Cancer Center medical records from 1990 to 2012 were reviewed. Patients who received chemotherapy with or without radiation therapy (RT), or RT alone, for completely resected stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation were included.ResultsOf 53 patients, International Federation of Gynecology and Obstetrics stage distribution was as follows: I, 13 (24.5%); II, 8 (15.1%); III, 13 (24.5%); and IV, 19 (35.9%). Forty-one (77.4%) of 53 patients received adjuvant chemotherapy, and 34% of the patients who received chemotherapy also received pelvic RT or intravaginal brachytherapy (IVRT). Twelve (22.6%) of the 53 patients received only pelvic RT with/without IVRT. Paclitaxel-carboplatin was the most commonly used adjuvant chemotherapy treatment. The median PFS for the entire cohort was 13.4 months (95% confidence interval [CI], 10.5–17.0). The median OS for the entire cohort was 23.0 months (95% CI, 16.9–34.3). The median PFS periods by stage were 15.9 months for stages I/II versus 11.2 months for stages III/IV (P= 0.012). Median OS was not reached in the early-stage cohort. The median OS for the late-stage cohort was 20.9 months (P= 0.004). The median PFS periods by treatment were 10.4 months for pelvic RT with/without IVRT group versus 13.1 months for chemotherapy with/without pelvic RT with/without IVRT group (P= 0.498). The median OS periods by treatment were 23.6 months for chemotherapy with/without pelvic RT with/without IVRT group versus 16.9 months for pelvic RT with/without IVRT group (P= 0.501).ConclusionThe results suggest that chemotherapy alone or in combination with RT is associated with longer PFS and OS compared to RT alone. Only the stage of disease significantly affected PFS and OS.

Pancreatic neuroendocrine tumors: Single institution review over 10 years.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15183-e15183
Author(s):  
Aakanksha Asija ◽  
Stacey Milan ◽  
Anthony Prestipino ◽  
Charles Yeo ◽  
Madhavan V. Pillai
Keyword(s):  
Surgical Resection ◽  
Median Survival ◽  
Neuroendocrine Tumors ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Tnm Staging ◽  
The Body ◽  
Stage I ◽  
University Hospital ◽  
Pancreatic Neuroendocrine Tumors

e15183 Background: Pancreatic neuroendocrine tumors(pNET) are rare tumors accounting for less than 5% of pancreatic cancer. They are functionally and biologically heterogeneous and have not been studied in great detail until recently. Methods: We conducted a retrospective review of 79 consecutive patients with pNET diagnosed and treated at Thomas Jefferson University Hospital between the years of 2000 and 2010. Results: Of the 79 patients whose records were reviewed, 32 were male and 47 were female. Median age at diagnosis was 61 years. Two cases were associated with MEN1 syndrome. Primary tumor arose in the head, body and tail of the pancreas in 15, 10 and 26 patients, resp. In 6 patients, the tumor was multifocal. The neuroendocrine tumor was accompanied by pancreatic adenocarcinoma in 1 patient and intraductal papillary mucinous neoplasm in 3. In 10 patients, distant metastasis was detected, involving liver only. Tumor was functional in 9 patients: 5 insulinoma, 2 gastrinoma,1 glucagonoma and 1 VIPoma. As per TNM staging, 28, 22 and 10 patients were Stage I, II and III, and IV at diagnosis. Treatment by surgical resection was undertaken in 54 patients. In 21 patients, the tumor was discovered incidentally; 21 patients presented with abdominal pain. Other symptoms were irregular bowel movements, weight loss and jaundice. 51 of the 79 (64.5%) patients were alive at last follow up. On univariate analysis, median survival for females was 137 months vs 114 months for male. Median survival for patients with functional tumors was similar to those with nonfunctioning tumors (118 and 115 months, resp). Median survival for patients with Stage I, II, and III and Stage IV patients were 234,112 and 40 months resp. Median survival for patients who underwent surgical resection was 130 months vs those who did not (30 months). Conclusions: Majority of pNET were located in the body and tail of pancreas; an area requiring thorough scrutiny with special imaging studies for diagnosis. Only a minority of patients presented with liver metastasis(12%) and a smaller number showed hormonal activity (11%). Prognosis improved markedly in patients who underwent surgical resection. Therefore, whenever appropriate, surgical resection should be the treatment of choice in patients with pNET.

Survival analyses of pancreatic neuroendocrine tumors: Contrasting institutional databases with population-based studies.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 186-186 ◽  
Author(s):  
J. R. Strosberg ◽  
T. R. Halfdanarson
Keyword(s):  
Neuroendocrine Tumors ◽  
Survival Rates ◽  
Stage Iv ◽  
Population Based ◽  
National Cancer Data Base ◽  
Pancreatic Neuroendocrine Tumors ◽  
Cancer Data ◽  
National Population ◽  
Population Databases ◽  
Prognostic Data

186 Background: Prognostic data in pancreatic neuroendocrine tumors derives from population-based studies as well as from institutional databases. Methods: The stage-stratified rates of 5-year survival derived from two institutional databases were contrasted with rates of 5-year survival derived from two national population-based studies (SEER 1973-2000 and National Cancer Data Base 1985-2004). Results: The 5-year survival rates derived from the two separate institutional databases were concordant with each other, but markedly higher than the 5-year survival rates derived from the population databases (Table). 5-year survival rates among stage IV patients were 55% and 57% in the institutional databases versus 15% and 19% in the population databases. Conclusions: Survival rates derived from institutional databases are substantially higher than survival rates derived from national population databases. The causes of these differences have yet to be clarified. [Table: see text] No significant financial relationships to disclose.

scholarly journals Progress and prospects of early detection in lung cancer

Open Biology ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. 170070 ◽  
Author(s):  
Sean Blandin Knight ◽  
Phil A. Crosbie ◽  
Haval Balata ◽  
Jakub Chudziak ◽  
Tracy Hussell ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Survival Rates ◽  
Case Series ◽  
Stage Iv ◽  
Small Cell ◽  
Stage I ◽  
Disease Stage ◽  
Molecular Stratification ◽  
The Uk

Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15–19% compared with 81–85% for stage I.

Risk of metastatic spread in patients with early-stage, surgically resected pancreatic neuroendocrine tumors.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 338-338
Author(s):  
J. R. Strosberg ◽  
A. Cheema ◽  
J. Weber ◽  
L. K. Kvols
Keyword(s):  
Neuroendocrine Tumors ◽  
Early Stage ◽  
Tnm Classification ◽  
Locally Advanced ◽  
Metastatic Spread ◽  
Cancer Center ◽  
Separate Analysis ◽  
Recurrence Free Survival ◽  
Pancreatic Neuroendocrine Tumors ◽  
Free Survival

338 Background: The risk of metastatic spread among patients with early-stage surgically resected pancreatic neuroendocrine tumors has not been well established. Methods: Patients with surgically resected localized or locally advanced pancreatic neuroendocrine tumors treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I-III) based on the new AJCC classification. Recurrence-free survival was measured for each stage. A separate analysis was performed excluding patients who had been referred to Moffitt Cancer Center after metastatic recurrence. Results: 123 patients with nonmetastatic, surgically resected pancreatic neuroendocrine tumors were identified. 5-year recurrence-free survival correlated with AJCC stage (p=0.01; Table). Conclusions: The novel AJCC 7th edition TNM classification for pancreatic neuroendocrine tumors is highly prognostic for recurrence in patients with surgically resected nonmetastatic tumors. [Table: see text] No significant financial relationships to disclose.

Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors

2011 ◽  
Vol 29 (22) ◽  
pp. 3044-3049 ◽  
Author(s):  
Jonathan R. Strosberg ◽  
Asima Cheema ◽  
Jill Weber ◽  
Gang Han ◽  
Domenico Coppola ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Proportional Hazards ◽  
Tnm Classification ◽  
Survival Rates ◽  
Tnm Staging ◽  
Cox Proportional Hazards ◽  
Cancer Center ◽  
Pancreatic Neuroendocrine Tumors ◽  
American Joint Committee ◽  
Staging Classification

Purpose The American Joint Committee on Cancer (AJCC) staging manual (seventh edition) has introduced its first TNM staging classification for pancreatic neuroendocrine tumors (NETs) derived from the staging algorithm for exocrine pancreatic adenocarcinomas. This classification has not yet been validated. Methods Patients with pancreatic NETs treated at the H. Lee Moffitt Cancer Center between 1999 and 2010 were assigned a stage (I to IV) based on the new AJCC classification. Kaplan-Meier analyses for overall survival (OS) were performed based on age, race, histologic grade, incidental diagnosis, and TNM staging (European Neuroendocrine Tumors Society [ENETS] v AJCC) using log-rank tests. Survival time was measured from time of initial diagnosis to date of last contact or date of death. Multivariate modeling was performed using Cox proportional hazards regression. Weighted Cohen's κ coefficient was computed to evaluate the agreement of ENETS and AJCC classifications. Results We identified 425 patients with pancreatic NETs. On the basis of histopathologic grade, 5-year survival rates for low-, intermediate-, and high-grade tumors were 75%, 62%, and 7%, respectively (P < .001). When using the ENETS classification, 5-year OS rates for stages I, II, III, and IV were 100%, 88%, 85%, and 57%, respectively (P < .001). Subsequently, using the AJCC classification, 5-year OS rates for stages I, II, III, and IV were 92%, 84%, 81%, and 57%, respectively (P < .001). Both the novel AJCC classification and the ENETS classification were highly prognostic for survival. Conclusion The AJCC TNM classification for pancreatic NETs is prognostic for OS and can be adopted in clinical practice.

Proposal of a two-step dynamic prognostic stratification for stage IV sporadic pancreatic neuroendocrine tumors

2016 ◽  
Author(s):  
Vincenzo Marotta ◽  
Thomas Walter ◽  
Cao Christine Do ◽  
Salvatore Tafuto ◽  
Vincenzo Montesarchio ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Stage Iv ◽  
Pancreatic Neuroendocrine Tumors ◽  
Prognostic Stratification

scholarly journals Serum Biomarker Signature-Based Liquid Biopsy for Diagnosis of Early-Stage Pancreatic Cancer

2018 ◽  
Vol 36 (28) ◽  
pp. 2887-2894 ◽  
Author(s):  
Linda D. Mellby ◽  
Andreas P. Nyberg ◽  
Julia S. Johansen ◽  
Christer Wingren ◽  
Børge G. Nordestgaard ◽  
...  
Keyword(s):  
Case Control Study ◽  
Early Stage ◽  
Stage Iv ◽  
The United States ◽  
Case Control ◽  
Stage I ◽  
Serum Biomarker ◽  
Patient Cohort ◽  
Biomarker Signature ◽  
Control Study

Purpose Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival of < 10% because of diffuse symptoms leading to late-stage diagnosis. That survival could increase significantly if localized tumors could be detected early. Therefore, we used multiparametric analysis of blood samples to obtain a novel biomarker signature of early-stage PDAC. The signature was derived from a large patient cohort, including patients with well-defined early-stage (I and II) PDAC. This biomarker signature was validated subsequently in an independent patient cohort. Patients and Methods The biomarker signature was derived from a case-control study, using a Scandinavian cohort, consisting of 16 patients with stage I, 132 patients with stage II, 65 patients with stage III, and 230 patients with stage IV PDAC, and 888 controls. This signature was validated subsequently in an independent case-control cohort in the United States with 15 patients with stage I, 75 patients with stage II, 15 patients with stage III, and 38 patients with stage IV PDAC, and 219 controls. An antibody microarray platform was used to identify the serum biomarker signature associated with early-stage PDAC. Results Using the Scandinavian case-control study, a biomarker signature was created, discriminating samples derived from patients with stage I and II from those from controls with a receiver operating characteristic area under the curve value of 0.96. This signature, consisting of 29 biomarkers, was then validated in an independent case-control study in the United States. The biomarker signature could discriminate patients with stage I and II PDAC from controls in this independent patient cohort with a receiver operating characteristic area under the curve value of 0.96. Conclusion This serum biomarker signature might represent a tenable approach to detecting early-stage, localized PDAC if these findings are supported by a prospective validation study.

XMAP230 is required for the assembly and organization of acetylated microtubules and spindles in Xenopus oocytes and eggs

1998 ◽  
Vol 111 (16) ◽  
pp. 2315-2327 ◽  
Author(s):  
B.J. Cha ◽  
B. Error ◽  
D.L. Gard
Keyword(s):  
Late Stage ◽  
Xenopus Oocytes ◽  
Early Stage ◽  
Polyclonal Antibodies ◽  
Stage Iv ◽  
Stage I ◽  
Meiotic Spindle ◽  
Heat Stable ◽  
Early Embryos ◽  
And Function

We used affinity-purified polyclonal antibodies to characterize the distribution and function of XMAP230, a heat-stable microtubule-associated protein isolated from Xenopus eggs, during oogenesis. Immunoblots revealed that XMAP230 was present throughout oogenesis and early development, but was most abundant in late stage oocytes, eggs, and early embryos. Immunofluorescence microscopy revealed that XMAP230 was associated with microtubules in oogonia, post-mitotic stage 0 oocytes, early stage I oocytes, and during stage IV-VI of oogenesis. However, staining of microtubules by anti-XMAP230 was not detectable during late stage I through stage III. In stage VI oocytes, anti-XMAP230 stained a large subset of microtubules that were also stained with monoclonal antibodies specific for acetylated (α)-tubulin. During oocyte maturation, XMAP230 was associated with the transient microtubule array that serves as the precursor of the first meiotic spindle, as well as both first and second meiotic spindles. The extensive array of cytoplasmic microtubules present throughout maturation was not detectably stained by anti-XMAP230. Microinjection of anti-XMAP230 locally disrupted the organization and acetylation of microtubules in stage VI oocytes, and reduced the re-acetylation of microtubules during recovery from cold-induced microtubule disassembly. Subsequent maturation of oocytes injected with anti-XMAP230 resulted in defects in the assembly of the transient microtubules array and first meiotic spindle. These observations suggest that XMAP230 is required for the stabilization and organization of cytoplasmic and spindle microtubules in Xenopus oocytes and eggs.

Stage at cancer diagnosis during the COVID-19 pandemic in western Washington state.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 145-145
Author(s):  
Catherine R. Fedorenko ◽  
Karma L. Kreizenbeck ◽  
Li Li ◽  
Laura Elizabeth Panattoni ◽  
Veena Shankaran ◽  
...  
Keyword(s):  
Medical Care ◽  
Early Stage ◽  
Stage Iv ◽  
Washington State ◽  
Stage I ◽  
Tumor Type ◽  
Stage At Diagnosis ◽  
Stage Iv Cancer ◽  
Using Data ◽  
The Impact

145 Background: The COVID-19 pandemic disrupted medical care, including routine cancer screening for breast, colorectal, lung and cervical cancers. We aimed to investigate the impact of the pandemic on stage at diagnosis for cancer patients. Methods: Using data from the Washington State SEER records we compared AJCC stage for patients diagnosed with cancer in 2017-2019 to 2020 for two time periods, March to June (initial pandemic months) and July to December (later pandemic months). Patients were included if they were age 18+, diagnosed with a solid tumor, and not diagnosed at autopsy. Results: In the early phase of the pandemic, March – June 2020, there was a shift to cancers being diagnosed at a later stage compared to the same time period in 2017-2019 (Stage III: 13.5% to 14.9%, Stage IV: 16.2% to 19.7%). There was also a decrease in cancer diagnoses for cancers that are often detected through routine screening. As a percentage of all cancer diagnoses, both melanoma (13.2% to 9.8%) and colon cancer diagnoses (7.2% to. 6.7%) decreased during the early pandemic. In the later phase of the pandemic, July to December 2020, the stage at diagnosis showed an indication of returning to pre-pandemic levels with an increase in the proportion of early stage cancers (In situ: 16.6% to 19.3%, Stage I: 38.8% to 41.1%). Stage at diagnosis trends varied by tumor type. For colorectal cancer, the overall number of diagnoses decreased during the initial pandemic months. Stage I diagnoses decreased and Stage IV cancer diagnoses increased in both early and late stages of the pandemic. Conclusions: In Washington State, the COVID-19 pandemic had an impact on stage at diagnosis potentially caused by delays or interruptions in medical care. Additional studies are needed to understand how this shift in stage at diagnosis impacted treatment and outcomes for patients.

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