scholarly journals Molecular prognostic factors in small-intestinal neuroendocrine tumours

2019 ◽  
Vol 8 (7) ◽  
pp. 906-922 ◽  
Author(s):  
K G Samsom ◽  
L M van Veenendaal ◽  
G D Valk ◽  
M R Vriens ◽  
M E T Tesselaar ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Loss Of Heterozygosity ◽  
Clinical Decision Making ◽  
Neuroendocrine Tumours ◽  
International Studies ◽  
Precision Oncology ◽  
Chromosome 18 ◽  
Genomic Aberration ◽  
Rare Tumours ◽  
Small Intestinal

Background Small-intestinal neuroendocrine tumours (SI-NETs) represent a heterogeneous group of rare tumours. In recent years, basic research in SI-NETs has attempted to unravel the molecular events underlying SI-NET tumorigenesis. Aim We aim to provide an overview of the current literature regarding prognostic and predictive molecular factors in patients with SI-NETs. Method A PubMed search was conducted on (epi)genetic prognostic factors in SI-NETs from 2000 until 2019. Results The search yielded 1522 articles of which 20 reviews and 35 original studies were selected for further evaluation. SI-NETs are mutationally quiet tumours with a different genetic make-up compared to pancreatic NETs. Loss of heterozygosity at chromosome 18 is the most frequent genomic aberration (44–100%) followed by mutations of CDKN1B in 8%. Prognostic analyses were performed in 16 studies, of which 8 found a significant (epi)genetic association for survival or progression. Loss of heterozygosity at chromosome 18, gains of chromosome 4, 5, 7, 14 and 20p, copy gain of the SRC gene and low expression of RASSF1A and P16 were associated with poorer survival. In comparison with genetic mutations, epigenetic alterations are significantly more common in SI-NETs and may represent more promising targets in the treatment of SI-NETs. Conclusion SI-NETs are mutationally silent tumours. No biomarkers have been identified yet that can easily be adopted into current clinical decision making. SI-NETs may represent a heterogeneous disease and larger international studies are warranted to translate molecular findings into precision oncology.

scholarly journals Prognostic factors for death after surgery for small intestinal neuroendocrine tumours

BJS Open ◽  
2018 ◽  
Vol 2 (5) ◽  
pp. 345-352 ◽  
Author(s):  
J. Eriksson ◽  
J. E. H. Garmo ◽  
C. Ihre-Lundgren ◽  
P. Hellman
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumours ◽  
Small Intestinal

Prognostic factors that mandate long term follow up following surgery for appendix neuroendocrine tumours (aNETs)

2016 ◽  
Author(s):  
Edward Alabraba ◽  
Heman Joshi ◽  
Andrea Tufo ◽  
Hassan Malik ◽  
Melissa Banks ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumours ◽  
Long Term Follow Up

scholarly journals Evolution of the Mesenteric Mass in Small Intestinal Neuroendocrine Tumours

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 443
Author(s):  
Anela Blažević ◽  
Tessa Brabander ◽  
Wouter T. Zandee ◽  
Johannes Hofland ◽  
Gaston J. H. Franssen ◽  
...  
Keyword(s):  
Neuroendocrine Tumours ◽  
Peptide Receptor Radionuclide Therapy ◽  
Size Reduction ◽  
Static Behavior ◽  
Recist 1.1 ◽  
Mesenteric Mass ◽  
Small Intestinal ◽  
Objective Size ◽  
Over Time

Background: A metastatic mesenteric mass is a hallmark of small intestinal neuroendocrine tumours (SI-NETs). However, little is known on its development over time. Therefore, we conducted a study to assess the evolution of a SI-NET-associated mesenteric mass over time. Methods: Retrospectively, 530 patients with proven SI-NET were included. The presence and growth of a mesenteric mass was assessed using RECIST 1.1 criteria on every consecutive CT-scan until the end of follow-up or resection. Results: At baseline, a mesenteric mass was present in 64% of the patients, of whom 13.5% showed growth of the mesenteric mass with a median time to growth of 40 months. Male gender was the only independent predictor of growth (OR 2.67). Of the patients without a mesenteric mass at the first evaluation, 2.6% developed a pathological mesenteric mass. Treatment with peptide receptor radionuclide therapy (PRRT; N = 132) resulted in an objective size reduction of the mesenteric mass in 3.8%. Conclusion: The metastatic mesenteric mass in SI-NETs has a static behavior over time. Therefore, site-specific growth behavior should be taken into account when selecting target lesions and assessing disease progression and therapeutic response. PRRT appears not to be effective for size reduction of the mesenteric mass.

Prognostic Factors for Persistent Symptoms in Adults With Mild Traumatic Brain Injury: an Overview of Systematic Reviews

2021 ◽  
Author(s):  
Julien Déry ◽  
Béatrice Ouellet ◽  
Élaine de Guise ◽  
Ève-Line Bussières ◽  
Marie-Eve Lamontagne
Keyword(s):  
Traumatic Brain Injury ◽  
Prognostic Factors ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Systematic Reviews ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Persistent Symptoms ◽  
Wide Range ◽  
Overview Of Systematic Reviews

Abstract Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, because of its persistent symptoms and several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide prevention of persistent symptoms following mTBI. Prognosis of mTBI has stimulated several empirical primary research papers and many systematic reviews leading to the identification of a wide range of factors. We aim to synthesize these factors to get a better understanding of their breadth and scope.Methods: We conducted an overview of systematic reviews. We searched in databases systematic reviews synthesizing evidence about prognosis of persistent symptoms after mTBI in the adult population. Two reviewers independently screened all references and selected eligible reviews based on eligibility criteria. They extracted relevant information using an extraction grid. They also rated independently the risk of bias using the ROBIS tool. We synthesized evidence into a comprehensive conceptual map to facilitate the understanding of prognostic factors that have an impact on persistent post-concussion symptoms.Results: From the 3857 references retrieved in database search, we included 25 systematic reviews integrating the results of 312 primary articles published between 1957 and 2019. We examined 35 prognostic factors from the systematics reviews. No single prognostic factor demonstrated convincing and conclusive results. However, age, sex and multiple concussions showed an affirmatory association with persistent post-concussion outcomes in systematic reviews.Conclusion: We highlighted the need of a comprehensive picture of prognostic factors related to persistent post-concussion symptoms. We believe that these prognostic factors would guide clinical decision and research related to prevention and intervention regarding persistent post-concussion symptoms.Systematic review registration: PROSPERO CRD42020176676

Evaluation of Clinical Prognostic Factors and Further Delineation of the Effect of Mesenteric Fibrosis on Survival in Advanced Midgut Neuroendocrine Tumours

2018 ◽  
Vol 107 (3) ◽  
pp. 292-304 ◽  
Author(s):  
Faidon-Marios Laskaratos ◽  
Martin Walker ◽  
Dominic Wilkins ◽  
Alexander Tuck ◽  
Shashank Ramakrishnan ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Large Scale ◽  
Neuroendocrine Tumours ◽  
Primary Tumour ◽  
Stage Iv ◽  
Epidemiological Data ◽  
Tumour Resection ◽  
Carcinoid Heart Disease ◽  
Factors Affecting ◽  
Stage Iv Disease

Background: Small intestinal neuroendocrine tumours (SI NETs) represent 30–50% of small bowel neoplasms and often present at an advanced stage. To date, there is relatively limited literature regarding prognostic factors affecting overall survival (OS) in stage IV disease. In addition, the prevalence of mesenteric fibrosis (MF) in SI NETs and its effect on OS have not been sufficiently explored in the literature. Aim: The primary aim of this study was to perform a large-scale survival analysis in an institutional cohort of 387 patients with metastatic (stage IV) SI NETs. The secondary aim was to provide epidemiological information regarding the prevalence of MF and to evaluate its effect on OS. Results: The median OS was 101 months (95% CI 84, 118). Age > 65 years, mesenteric metastases with and without desmoplasia, liver metastases, carcinoid heart disease (CHD) and bone metastases were associated with a significantly shorter OS, while primary tumour resection was predictive of a longer OS. The benefit of surgical resection was limited to symptomatic patients. MF was present in approximately 50% of patients with mesenteric lymphadenopathy. Elevated urinary 5-HIAA levels correlated strongly with the presence of CHD (p < 0.001) and to a lesser extent (p = 0.02) with MF. MF and CHD did not usually co-exist, suggesting that different mechanisms are likely to be involved in the development of these fibrotic complications. Conclusions: This study has identified specific prognostic factors in a large cohort of 387 patients with advanced SI NETs and has provided useful epidemiological data regarding carcinoid-related fibrotic complications.

Extra-Pulmonary Neuroendocrine Carcinomas: A Population-Based Study in the Netherlands

2018 ◽  
Vol 107 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Jan Maarten van der Zwan ◽  
Sabine Siesling ◽  
Loes van Velthuysen ◽  
Thera Links ◽  
Annemiek Walenkamp ◽  
...  
Keyword(s):  
The Netherlands ◽  
Clinical Decision Making ◽  
Relative Survival ◽  
Unknown Primary ◽  
Female Ratio ◽  
Netherlands Cancer Registry ◽  
Number Of Patients ◽  
Rare Tumours ◽  
Extra Pulmonary ◽  
Neuroendocrine Carcinomas

Background: Extra-pulmonary neuroendocrine carcinomas (EP-NEC) are rare tumours that require expertise for correct and timely diagnosis, which is essential for clinical decision making. The number of patients affected, treatment given, and the proportion surviving the disease is based on limited evidence. The aim of this study is to retrospectively analyse the incidence, treatment, and relative survival (RS) of EP-NEC patients in the Netherlands. Methods: Patients diagnosed between 2008–2012 with EP-NEC or NEC with unknown primary site (UP-NEC) were selected from the Netherlands Cancer Registry based on combinations of tumour localisation and morphology code. Incidence was studied using the European standardised (ESR) and world standardised rates, and RS was calculated using the Ederer II method. Results: In total, 1,544 cases were analysed, 1,045 EP-NEC and 499 UP-NEC. For EP-NEC, the incidence was 1.0 per 100,000 person-years (ESR), the mean age was 68 years, and the male to female ratio was 1: 0.6. Most frequent EP-NEC localisations were the bladder and the gastrointestinal tract, and the treatment most frequently given was surgery in combination with chemotherapy. The overall 5-year RS was 38% for patients with local/regional disease (n = 447), and 7% for patients with extensive disease (n = 582). For UP-NEC patients (n = 499), the 5-year RS was 6%. Conclusions: This study is the first nationwide study presenting an increase in the incidence of EP-NEC patients from 196 to 260 cases annually in the Netherlands. The best 5-year RS was found for EP-NEC patients with local disease located in the bladder, where the worst 5-year RS was found for patients with disease located in the oesophagus.

The Johns Hopkins Molecular Tumor Board Precision Oncology elective for Medical Oncology fellows.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11035-11035
Author(s):  
Kristen Marrone ◽  
Jessica Tao ◽  
Jenna VanLiere Canzoniero ◽  
Paola Ghanem ◽  
Emily Nizialek ◽  
...  
Keyword(s):  
Decision Making ◽  
Precision Medicine ◽  
Clinical Decision Making ◽  
Cancer Genomics ◽  
Medical Oncology ◽  
Clinical Decision ◽  
Tumor Board ◽  
Precision Oncology ◽  
Adaptive Expertise ◽  
Molecular Tumor Board

11035 Background: The accelerated impact of next generation sequencing (NGS) in clinical decision making requires the integration of cancer genomics and precision oncology focused training into medical oncology education. The Johns Hopkins Molecular Tumor Board (JH MTB) is a multi-disciplinary effort focused on integration of NGS findings with critical evidence interpretation to generate personalized recommendations tailored to the genetic footprint of individual patients. Methods: The JH MTB and the Medical Oncology Fellowship Program have developed a 3-month precision oncology elective for fellows in their research years. Commencing fall of 2020, the goals of this elective are to enhance the understanding of NGS platforms and findings, advance the interpretation and characterization of molecular assay outputs by use of mutation annotators and knowledgebases and ultimately master the art of matching NGS findings with available therapies. Fellow integration into the MTB focuses on mentored case-based learning in mutation characterization and ranking by levels of evidence for actionability, with culmination in form of verbal presentations and written summary reports of final MTB recommendations. A mixed methods questionnaire was administered to evaluate progress since elective initiation. Results: Three learners who have participated as of February 2021 were included. Of the two who had completed the MTB elective, each have presented at least 10 cases, with at least 1 scholarly publication planned. All indicated strong agreement that MTB elective had increased their comfort with interpreting clinical NGS reports as well as the use of knowledgebases and variant annotators. Exposure to experts in the field of molecular precision oncology, identification of resources necessary to interpret clinical NGS reports, development of ability to critically assess various NGS platforms, and gained familiarity with computational analyses relevant to clinical decision making were noted as strengths of the MTB elective. Areas of improvement included ongoing initiatives that involve streamlining variant annotation and transcription of information for written reports. Conclusions: A longitudinal elective in the JHU MTB has been found to be preliminarily effective in promoting knowledge mastery and creating academic opportunities related to the clinical application of precision medicine. Future directions will include leveraging of the MTB infrastructure for research projects, learner integration into computational laboratory meetings, and expansion of the MTB curriculum to include different levels of learners from multiple medical education programs. Continued elective participation will be key to understanding how best to facilitate adaptive expertise in assigning clinical relevance to genomic findings, ultimately improving precision medicine delivery in patient care and trial development.

scholarly journals PO-329 Genomic aberration in pancreatic neuroendocrine tumours (PNET)

2018 ◽  
Author(s):  
T Simon ◽  
S Mamlouk ◽  
S Khouja ◽  
M Andrea ◽  
L Dido ◽  
...  
Keyword(s):  
Neuroendocrine Tumours ◽  
Genomic Aberration ◽  
Pancreatic Neuroendocrine Tumours

Successful treatment of prolonged postoperative ileus following resection of a small intestinal spindle cell sarcoma in a horse

2019 ◽  
Vol 7 (3) ◽  
pp. e000899
Author(s):  
Janny de Grauw ◽  
Thijs van Loon
Keyword(s):  
Postoperative Ileus ◽  
Clinical Decision Making ◽  
Spindle Cell ◽  
Clinical Decision ◽  
Spindle Cell Sarcoma ◽  
Emergency Laparotomy ◽  
Prokinetic Drug ◽  
Prolonged Postoperative Ileus ◽  
Small Intestinal ◽  
Enteral And Parenteral Nutrition

This case report details the unusual clinical course of a horse that had been hospitalised for recurrent colic prior to an acute colic episode requiring emergency laparotomy. Within the first 24 hours after surgery, the horse developed severe colic and postoperative ileus (POI) requiring repeat laparotomy. The horse suffered persistent ileus with copious reflux for 8 days thereafter, but its clinical condition permitted continued treatment. It was discharged after 4 weeks and returned to its previous performance level. The authors describe clinical decision-making regarding intravenous fluid therapy, prokinetic drug administration, enteral and parenteral nutrition, and institution of physical exercise in the treatment of persistent POI. Economic and welfare considerations allowing, equine POI may resolve even in protracted cases. Patients may benefit from strategies aimed at early enteral feeding and ambulation as have emerged in human POI management.

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