PMID- 11408501
OWN - NLM
STAT- MEDLINE
DCOM- 20010705
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 19
IP  - 12
DP  - 2001 Jun 15
TI  - Prognostic value of initial fasting serum gastrin levels in patients with 
      Zollinger-Ellison syndrome.
PG  - 3051-7
AB  - PURPOSE: To assess the value of the initial fasting serum gastrin (FSG) at 
      presentation in patients with Zollinger-Ellison Syndrome (ZES) in predicting 
      primary tumor characteristics and survival. PATIENTS AND METHODS: A total of 239 
      patients were treated for ZES between December 1981 and September 1998, with a 
      mean follow-up of 9.1 +/- 0.6 years. At initial evaluation, 86 patients (36%) had 
      mild (0 to 499 pg/mL), 61 (25.5%) had moderate (500 to 1,000 pg/mL), and 92 
      (38.5%) had severe (> 1,000 pg/mL) elevations in FSG. Primary tumor location and 
      size, presence of lymph node or hepatic metastases, and survival were analyzed 
      based on the level of initial FSG. RESULTS: In patients with sporadic ZES, but 
      not in those with multiple endocrine neoplasia type 1 (MEN-1) and ZES, there was 
      a significant relationship between the level of initial FSG and tumor size and 
      location of primary tumor, frequency of lymph node and liver metastases, and 
      survival. The median 5- and 10-year survival decreased with increasing initial 
      FSG (P <.001) in patients with sporadic ZES; MEN-1 patients lived longer than 
      sporadic ZES patients (P =.012), and survival in this group was not associated 
      with the level of initial FSG. Multivariate analysis showed that factors 
      independently associated with death from disease in patients with sporadic ZES 
      were liver metastases (P =.0001), a pancreatic site (P =.0027), and primary tumor 
      size (P =.011) but not initial FSG (P >.30). CONCLUSION: The severity of FSG at 
      presentation is associated with size and site of tumor and the presence of 
      hepatic metastases, factors that are significant independent predictors of 
      outcome. The level of FSG at presentation may be useful in planning the nature 
      and extent of the initial evaluation and management in patients with sporadic 
      ZES.
FAU - Berger, A C
AU  - Berger AC
AD  - Surgery Branch and Biostatistics and Data Management Section, Center for Cancer 
      Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 
      20892, USA.
FAU - Gibril, F
AU  - Gibril F
FAU - Venzon, D J
AU  - Venzon DJ
FAU - Doppman, J L
AU  - Doppman JL
FAU - Norton, J A
AU  - Norton JA
FAU - Bartlett, D L
AU  - Bartlett DL
FAU - Libutti, S K
AU  - Libutti SK
FAU - Jensen, R T
AU  - Jensen RT
FAU - Alexander, H R
AU  - Alexander HR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Gastrins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/*blood
MH  - Child
MH  - Female
MH  - Gastrins/*blood
MH  - Humans
MH  - Incidence
MH  - Liver Neoplasms/epidemiology/secondary
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Survival Analysis
MH  - Survival Rate
MH  - United States/epidemiology
MH  - Zollinger-Ellison Syndrome/*diagnosis/mortality/pathology
EDAT- 2001/06/16 10:00
MHDA- 2001/07/06 10:01
CRDT- 2001/06/16 10:00
PHST- 2001/06/16 10:00 [pubmed]
PHST- 2001/07/06 10:01 [medline]
PHST- 2001/06/16 10:00 [entrez]
AID - 10.1200/JCO.2001.19.12.3051 [doi]
PST - ppublish
SO  - J Clin Oncol. 2001 Jun 15;19(12):3051-7. doi: 10.1200/JCO.2001.19.12.3051.