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    The management and outcomes of patients with extra-pulmonary neuroendocrine neoplasms and brain metastases

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    Authors
    Kapacee, Zainul Abedin
    Allison, Jennifer
    Dawod, Mohammed
    Wang, Xin
    Frizziero, Melissa
    Chakrabarty, Bipasha
    Manoharan, Prakash
    McBain, Catherine A
    Mansoor, Was
    Lamarca, Angela
    Hubner, Richard A
    Valle, Juan W
    McNamara, Mairead G
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    Affiliation
    Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK
    Issue Date
    2022
    
    Metadata
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    Abstract
    Background: Brain metastases (BMs) in patients with extra-pulmonary neuroendocrine neoplasms (EP-NENs) are rare, and limited clinical information is available. The aim of this study was to detail the clinicopathological features, management and outcomes in patients with EP-NENs who developed BMs. Methods: A retrospective single-centre analysis of consecutive patients with EP-NENs (August 2004-February 2020) was conducted. Median overall survival (OS)/survival from BMs diagnosis was estimated (Kaplan-Meier). Results: Of 730 patients, 17 (1.9%) had BMs, median age 61 years (range 15-77); 8 (53%) male, unknown primary NEN site: 40%. Patients with BMs had grade 3 (G3) EP-NENs 11 (73%), G2: 3 (20%), G1: 1 (7%). Eight (53%) had poorly differentiated NENs, 6 were well-differentiated and 1 was not recorded. Additionally, 2 (13%) patients had synchronous BMs at diagnosis, whilst 13 (87%) developed BMs metachronously. The relative risk of developing BMs was 7.48 in patients with G3 disease vs. G1 + G2 disease (p = 0.0001). Median time to the development of BMs after NEN diagnosis: 15.9 months (range 2.5-139.5). Five patients had a solitary BM, 12 had multiple BMs. Treatment of BMs were surgery (n = 3); radiotherapy (n = 5); 4: whole brain radiotherapy, 1: conformal radiotherapy (orbit). Nine (53%) had best supportive care. Median OS from NEN diagnosis was 23.6 months [95% CI 15.2-31.3]; median time to death from BMs diagnosis was 3.0 months [95% CI 0.0-8.3]. Conclusion: BMs in patients with EP-NENs are rare and of increased risk in G3 vs. G1 + G2 EP-NENs. Survival outcomes are poor, and a greater understanding is needed to improve therapeutic outcomes.
    Citation
    Kapacee ZA, Allison J, Dawod M, Wang X, Frizziero M, Chakrabarty B, et al. The Management and Outcomes of Patients with Extra-Pulmonary Neuroendocrine Neoplasms and Brain Metastases. Current oncology (Toronto, Ont). 2022 Jul 20;29(7):5110-25. PubMed PMID: 35877265. Pubmed Central PMCID: 9319979. Epub 2022/07/26. eng.
    Journal
    Current Oncology
    URI
    http://hdl.handle.net/10541/625447
    DOI
    10.3390/curroncol29070405
    PubMed ID
    35877265
    Additional Links
    https://dx.doi.org/10.3390/curroncol29070405
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.3390/curroncol29070405
    Scopus Count
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