Incidence of Second Primary Malignancies in Patients with Neuroendocrine Tumours
Artikel i vetenskaplig tidskrift, 2015

Background: An association between neuroendocrine tumours (NET) and increased risk of developing second primary malignancies (SPM) has been recognised. Methods: This was a retrospective review of our institutional prospectively maintained database of NET patients. We identified patients who had been diagnosed with both neuroendocrine and any additional malignancies via examination of patient notes. Results: Clinical data for 169 patients were analysed. After exclusion of patients known to have hereditary tumour predisposition syndromes, 29 SPM were identified in 26 patients (15.38%), the commonest being colorectal (n = 6), breast and renal carcinomas (both n = 5). SPM were classified as previous, synchronous or subsequent relative to NET diagnosis. Rates of SPM in pancreatic and small-bowel NET patients were comparable (15.7 vs. 19.6%, p = 0.78). A personyear methodology was used to compare observed numbers of SPM against expected values generated from age-and sex-specific incidence tables, with standardised incidence ratios (SIR) and 95% confidence intervals (CI) calculated. SPM incidence was significantly elevated in the synchronous subset (SIR 2.732, CI 1.177-5.382) whilst significantly fewer NET patients had a cancer history compared to the general population (SIR 0.4, CI 0.241-0.624). No overall differences were evident between observed and expected incidences of subsequent SPM (SIR 0.36, CI 0.044-1.051). The incidence of synchronous colorectal cancers was markedly elevated (SIR 13.079, CI 4.238-30.474). Conclusions: Our data support the use of colonoscopy in the diagnostic work-up of NET patients in anticipation of a colorectal SPM. The mechanistic underpinnings of this clinical phenomenon require further genetic investigation, and consideration of this knowledge in patient management pathways is warranted. (C) 2015 S. Karger AG, Basel

Neuroendocrine tumour

risk

neoplasms

Neurosciences & Neurology

Second primary cancer

cancer survivors

carcinoids

receptors

tract

Endocrinology & Metabolism

gastrin

Författare

A. K. Clift

P. Drymousis

A. Al-Nahhas

H. Wasan

J. Martin

Sture Holm

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

A. Frilling

Neuroendocrinology

0028-3835 (ISSN) 1423-0194 (eISSN)

Vol. 102 1-2 26-32

Ämneskategorier

Endokrinologi och diabetes

Neurologi

DOI

10.1159/000381716

PubMed

25824138

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2017-10-08