Chest metastases in advanced small bowel neuroendocrine neoplasms: incidence and outcome

Background and Aim: Small-bowel neuroendocrine neoplasm (sbNEN) diagnosis has improved with double-balloon enteroscopy (DBE). DBE efficacy in the detection of sbNENs is unknown. We aimed to report the experience at a single referral center for NENs. Methods: All consecutive patients with a suspected sbNEN selected for diagnostic DBE were enrolled. Results: Between 2011 and 2016, 25 patients were referred for a suspected sbNEN. In 15/25 patients, a primary NEN was detected outside the small bowel; in 4, NEN was excluded. After extensive workup, 6 patients (4 males, median age 50 years) underwent DBE (3 anterograde, 2 retrograde, and 1 both; median time: 60 min; median insertion 200 cm). DBE was positive in 3 patients: one had an ileal 2-cm NEN G1, one had an ileal 1.3-cm NEN G1, and one had an ileal 1-cm NEN G2, all surgically removed. Of the 3 other patients, one had a metastatic NEN of unknown primary, the other two had small intestinal NENs, both surgically removed (1.6-cm G1 and G2 NEN). DBE showed a sensitivity of 60% and, in absence of false-positive results, a specificity of 100%. Accuracy resulted 67%. No complications were observed. Conclusions: In line with data from the literature, the present series showed that DBE is a safe and effective procedure in the diagnosis of sbNENs. Further studies are needed to better clarify the diagnostic role of DBE in the neuroendocrine tumor setting and its relationship with other techniques.

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Post‐operative morbidity and mortality after surgical resection of small bowel neuroendocrine neoplasms: a systematic review and meta‐analysis

Journal of Neuroendocrinology ◽

10.1111/jne.13008 ◽

2021 ◽

Author(s):

E. Kaçmaz ◽

J.W. Chen ◽

P.J. Tanis ◽

E.J.M. Nieveen van Dijkum ◽

A.F. Engelsman

Keyword(s):

Systematic Review ◽

Small Bowel ◽

Surgical Resection ◽

Meta Analysis ◽

Morbidity And Mortality ◽

Neuroendocrine Neoplasms ◽

Operative Morbidity

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Effectiveness of peptide receptor radionuclide therapy for neuroendocrine neoplasms: A multi-institutional registry study with prospective follow-up.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.4033 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 4033-4033

Author(s):

Dieter Hörsch ◽

Keyword(s):

Small Bowel ◽

Radionuclide Therapy ◽

Peptide Receptor Radionuclide Therapy ◽

Progression Free Survival ◽

Unknown Primary ◽

Neuroendocrine Neoplasms ◽

Registry Study ◽

Free Survival ◽

Peptide Receptor ◽

Well Differentiated

4033 Background: Peptide receptor radionuclide therapy targets somatostatin receptors expressed on well differentiated neuroendocrine neoplasms. Retrospective monocentric studies indicate that peptide receptor radionuclide therapy is an effective treatment for patients with neuroendocrine neoplasms. Methods: We initiated a multi-institutional, prospective and board reviewed registry study for patients treated with peptide receptor radionuclide therapy. 450 patients were included and followed for a mean of 24.4 months. Patients were treated with Lutetium-177 (54%), Yttrium-90 (17%) or both radionuclides (29%). Primary neuroendocrine neoplasms were derived of pancreas (38%), small bowel 30%), unknown primary (19%), lung (4%) and colorectum (3,5%). Most neuroendocrine neoplasms were well differentiated with a proliferation rate below 20% in 54% and were pretreated by 1 or more therapies in 73%. Results: Overall survival of all patients from the beginning of therapy was 59 months in median. Median survival depended on radionuclides used (Yttrium-90: 38 months; Lutetium-177: not reached; both: 58 months), proliferation rate (G1: median not reached; G2: 58 months; G3: 33 months; unknown: 55 months) and origin of primary tumors (pancreas: 53 months; small bowel: not reached; unknown primary: 47 months; lung: 38 months) but not upon number of previous therapies. Median progression-free survival measured from last cycle of therapy accounted to 41 months for all patients. Progression-free survival of pancreatic neuroendocrine neoplasms was 39 months in median. Similar results were obtained for neuroendocrine neoplasms of unknown primary with a median of 38 months whereas neuroendocrine neoplasm of small bowel were progression-free for a median of 51 months. Side effects like G3-G4 nephrotoxicity or hematological function were observed in 0.2% and 2% of patients. Conclusions: Peptide receptor radionuclide therapy is effective for patients with G1-G2 neuroendocrine tumors irrespective of previous therapies with a survival advantage of several years compared to other therapies and only minor side effects.

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Long-term efficacy of 90Y-DOTATATE in patients with nonresectable pancreatic and small bowel neuroendocrine neoplasms

Future Oncology ◽

10.2217/fon-2016-0031 ◽

2016 ◽

Vol 12 (16) ◽

pp. 1877-1885 ◽

Cited By ~ 6

Author(s):

Wojciech Rogowski ◽

Ewa Wachuła ◽

Anna Lewczuk ◽

John R Buscombe ◽

Nina Seklecka ◽

...

Keyword(s):

Small Bowel ◽

Neuroendocrine Neoplasms ◽

Term Efficacy

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Value of Laparoscopy for Resection of Small Bowel Neuroendocrine Neoplasms Including Central Mesenteric Lymphadenectomy

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001915 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 1

Author(s):

Enes Kaçmaz ◽

Susanne van Eeden ◽

Josephina C.C. Koppes ◽

Heinz-Josef Klümpen ◽

Willem A. Bemelman ◽

...

Keyword(s):

Small Bowel ◽

Neuroendocrine Neoplasms

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Expression of the Chemokine Receptor CXCR2 in Normal and Neoplastic Neuroendocrine Cells

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-0520-eotcrc ◽

2000 ◽

Vol 124 (4) ◽

pp. 520-525 ◽

Cited By ~ 1

Author(s):

Tülay Tecimer ◽

Jeffrey Dlott ◽

Anan Chuntharapai ◽

Alvin W. Martin ◽

Stephen C. Peiper

Keyword(s):

Small Bowel ◽

Immunohistochemical Analysis ◽

Large Cell ◽

Small Cell ◽

Neuroendocrine Cells ◽

Biologically Active ◽

Neuroendocrine Neoplasms ◽

Projection Neurons ◽

Cxcr2 Expression ◽

High Level

Abstract Background.—Chemokines effect their proinflammatory and growth regulatory roles through interaction with serpentine receptors. One such receptor, CXCR2, binds multiple CXC chemokines, including interleukin 8, GRO-α, GRO-β, GRO-γ, and NAP-2. We have previously identified CXCR2 expression on myeloid cells, notably mature granulocytes, and projection neurons. Objective.—To determine the expression of CXCR2 by cells of the neuroendocrine system. Design.—Archival specimens from normal neuroendocrine tissues and their malignant counterparts were analyzed by immunohistochemistry with monoclonal antibodies specific for CXCR1 and CXCR2. Results.—Immunohistochemical analysis revealed high-level expression of CXCR2 by cells in the pituitary, adrenal medulla, pancreatic islets, thyroid C cells, scattered Kulchitsky cells in the bronchi, and counterpart neuroendocrine cells in the stomach, small bowel, colon, and appendix. Neuroendocrine neoplasms that demonstrated high-level CXCR2 expression included (1) primary carcinoids localized to the stomach, small bowel, colon, appendix, fallopian tube, ovary, and lung; (2) atypical carcinoids of the lung; (3) metastatic carcinoids; (4) pituitary adenomas; (5) pheochromocytomas; and (6) medullary carcinomas of the thyroid. Small cell lung carcinomas, large cell neuroendocrine carcinomas of the lung, small cell carcinoma of the cervix, Merkel cell carcinomas, neuroblastomas, and malignant melanomas lacked evidence of CXCR2 expression. Conclusions.—The expression of CXCR2 by normal neuroendocrine cells and neoplastic counterparts that have retained phenotypic features of this differentiation program suggests that chemokines may play an important role in functions that are characteristic of this cell type. In addition, this raises the possibility that chemokines may modulate secretion of biologically active products of these cells and their neoplastic counterparts.

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Fluorescence angiography guided resection of small bowel neuroendocrine neoplasms with mesenteric lymph node metastases

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2020.12.008 ◽

2021 ◽

Author(s):

E. Kaçmaz ◽

M.D. Slooter ◽

E.J.M. Nieveen van Dijkum ◽

P.J. Tanis ◽

A.F. Engelsman

Keyword(s):

Lymph Node ◽

Small Bowel ◽

Mesenteric Lymph Node ◽

Lymph Node Metastases ◽

Fluorescence Angiography ◽

Neuroendocrine Neoplasms ◽

Mesenteric Lymph ◽

Node Metastases

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Update on Incidence, Prevalence, Treatment and Survival of Patients with Small Bowel Neuroendocrine Neoplasms in the Netherlands

World Journal of Surgery ◽

10.1007/s00268-021-06119-y ◽

2021 ◽

Author(s):

Enes Kaçmaz ◽

Arantza Farina Sarasqueta ◽

Susanne van Eeden ◽

Koen M. A. Dreijerink ◽

Heinz-Josef Klümpen ◽

...

Keyword(s):

Small Bowel ◽

The Netherlands ◽

Survival Data ◽

Primary Tumour ◽

Stage Iv ◽

Incidence Rates ◽

Stage Iii ◽

Neuroendocrine Neoplasms ◽

Netherlands Cancer Registry ◽

Adjusted Incidence

Abstract Background Small bowel neuroendocrine neoplasms (SB-NEN) are rare cancers, population-based studies are needed to study this rare indolent disease. The aim of this study was to explore trends in epidemiology, treatment and survival outcomes of patients with SB-NEN based on Dutch nationwide data. Patients and methods Patients with grade 1 or 2 SB-NEN diagnosed between 2005 and 2015 were retrieved from the Netherlands Cancer Registry and linked to The Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands. Age-adjusted incidence rates were calculated based using the direct standardization method. Survival analyses were performed with the Kaplan–Meier method. Results A total of 1132 patients were included for epidemiological analyses. The age-adjusted incidence rate of SB-NEN increased from 0.52 to 0.81 per 100.000 person-years between 2005 and 2015. Incidence was higher for males than females (0.93 vs. 0.69 in 2015). Most patients had grade 1 tumours (83%). Surgery was performed in 86% of patients, with resection of the primary tumour in 99%. During the study period, administration of somatostatin analogues (SSAs) increased from 5 to 22% for stage III and from 27 to 63% for stage IV disease. Mean follow-up was 61 (standard deviation 38) months. Survival data were complete for 975/1132 patients and five-year overall survival was 75% for stage I-II, 75% for stage III and 57% for stage IV. Conclusions This study shows an increase in the incidence of SB-NEN in the Netherlands. A predominant role of surgery was found in all disease stages. Use of SSAs has increased over time.

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