PMID- 30530877
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2049-3614 (Print)
IS  - 2049-3614 (Electronic)
IS  - 2049-3614 (Linking)
VI  - 7
IP  - 12
DP  - 2018 Dec
TI  - Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age.
PG  - 1535-1541
LID - 10.1530/EC-18-0478 [doi]
AB  - The incidence of neuroendocrine neoplasia (NEN) is higher in individuals >/=70 
      years of age (elderly) who are underrepresented in clinical trials because of 
      comorbidities and low performance status. We retrospectively analyzed the outcome 
      of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by 
      Charlson Comorbidity Index (CCI), Kaplan-Meier method was applied to estimate 
      overall survival (OS) and Cox's proportional hazard model was used to assess the 
      impact of known prognostic factors. We retrieved data on 145 mNEN patients aged 
      >/=70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were 
      aged >/=75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 
      37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. 
      Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of 
      cases, respectively. Median follow-up was 72.3 (53.2-85.1) months. Seventy-nine 
      patients received first-line somatostatin analogs (SSA), 23 peptide receptor 
      radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo 
      first-line therapy and 102 received more than one line. Median overall survival 
      (mOS) was 5.1 years (95% CI: 3.4-6.6). No differences in mOS were seen according 
      to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3-not reached 
      (NR)), SSA 5.7 years (95% CI: 4.2-7) and CHT 5.9 years (95% CI: 0.4-NR). mOS in 
      CHT-treated G3 patients was 1.5 years (1.0-2.5). ECOG PS and FDG PET/CT were 
      identified as independent prognostic factors. Results suggest that the above 
      treatments positively impacted OS in elderly mNEN patients, including those aged 
      >/=75 years.
FAU - Bongiovanni, Alberto
AU  - Bongiovanni A
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Recine, Federica
AU  - Recine F
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Foca, Flavia
AU  - Foca F
AD  - Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo 
      Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Fausti, Valentina
AU  - Fausti V
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Riva, Nada
AU  - Riva N
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Fabbri, Greta
AU  - Fabbri G
AD  - Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo 
      Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Severi, Stefano
AU  - Severi S
AD  - Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei 
      Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Liverani, Chiara
AU  - Liverani C
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - De Vita, Alessandro
AU  - De Vita A
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Spadazzi, Chiara
AU  - Spadazzi C
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Miserocchi, Giacomo
AU  - Miserocchi G
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Mercatali, Laura
AU  - Mercatali L
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Amadori, Dino
AU  - Amadori D
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Ibrahim, Toni
AU  - Ibrahim T
AD  - Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio 
      e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Endocr Connect
JT  - Endocrine connections
JID - 101598413
PMC - PMC6311458
OTO - NOTNLM
OT  - elderly patients
OT  - neuroendocrine carcinoma
OT  - neuroendocrine neoplasia
OT  - neuroendocrine tumors
EDAT- 2018/12/12 06:00
MHDA- 2018/12/12 06:01
PMCR- 2018/12/07
CRDT- 2018/12/12 06:00
PHST- 2018/12/03 00:00 [received]
PHST- 2018/12/07 00:00 [accepted]
PHST- 2018/12/12 06:00 [pubmed]
PHST- 2018/12/12 06:01 [medline]
PHST- 2018/12/12 06:00 [entrez]
PHST- 2018/12/07 00:00 [pmc-release]
AID - EC-18-0478.R1 [pii]
AID - EC-18-0478 [pii]
AID - 10.1530/EC-18-0478 [doi]
PST - ppublish
SO  - Endocr Connect. 2018 Dec;7(12):1535-1541. doi: 10.1530/EC-18-0478.