PMID- 31401809
OWN - NLM
STAT- MEDLINE
DCOM- 20191023
LR  - 20210110
IS  - 1096-9098 (Electronic)
IS  - 0022-4790 (Print)
IS  - 0022-4790 (Linking)
VI  - 120
IP  - 6
DP  - 2019 Nov
TI  - Prognostic factors and survival in MEN1 patients with gastrinomas: Results from 
      the DutchMEN study group (DMSG).
PG  - 966-975
LID - 10.1002/jso.25667 [doi]
AB  - BACKGROUND AND OBJECTIVES: Gastrinomas are the most prevalent functioning 
      neuroendocrine tumors (NET) in multiple endocrine neoplasia type 1 (MEN1). 
      Guidelines suggest medical therapy in most patients, but surgery may be 
      considered in a subgroup. Currently, factors to guide management are necessary. 
      This population-based cohort study assessed prognostic factors of survival in 
      patients with MEN1-related gastrinomas. METHODS: Patients with MEN1 having 
      gastrinomas were identified in the Dutch MEN1 database from 1990 to 2014 based on 
      fasting serum gastrin (FSG) levels and/or pathology. Predictors of overall 
      survival were assessed using Cox regression. RESULTS: Sixty-three patients with 
      gastrinoma (16% of the MEN1 population) were identified. Five- and 10-year 
      overall survival rates were 83% and 65%, respectively. Prognostic factors 
      associated with overall survival were initial FSG levels >/=20x upper limit of 
      normal (ULN) (hazard ratio [HR], 6.2 [95% confidence interval, 1.7-23.0]), 
      pancreatic NET >/=2 cm (HR 4.5; [1.5-13.1]), synchronous liver metastases (HR 8.9; 
      [2.1-36.7]), gastroduodenoscopy suspicious for gastric NETs (HR 12.7; 
      [1.4-115.6]), and multiple concurrent NETs (HR 5.9; [1.2-27.7]). CONCLUSION: Life 
      expectancy of patients with MEN1 gastrinoma is reduced. FSG levels and pancreatic 
      NETs >/=2 cm are prognostic factors. FSG levels might guide surveillance intensity, 
      step-up to additional diagnostics, or provide arguments in selecting patients who 
      might benefit from surgery.
CI  - (c) 2019 The Authors. Journal of Surgical Oncology published by Wiley Periodicals, 
      Inc.
FAU - van Beek, Dirk-Jan
AU  - van Beek DJ
AUID- ORCID: 0000-0001-7834-8128
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Nell, Sjoerd
AU  - Nell S
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Pieterman, Carolina R C
AU  - Pieterman CRC
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The 
      Netherlands.
FAU - de Herder, Wouter W
AU  - de Herder WW
AD  - Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The 
      Netherlands.
FAU - van de Ven, Annenienke C
AU  - van de Ven AC
AD  - Department of Endocrinology, Radboud University Medical Center, Nijmegen, The 
      Netherlands.
FAU - Dekkers, Olaf M
AU  - Dekkers OM
AD  - Departments of Endocrinology and Metabolism and Clinical Epidemiology, Leiden 
      University Medical Center, Leiden, The Netherlands.
FAU - van der Horst-Schrivers, Anouk N
AU  - van der Horst-Schrivers AN
AD  - Department of Endocrinology, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands.
FAU - Drent, Madeleine L
AU  - Drent ML
AD  - Department of Internal Medicine, Section of Endocrinology, Amsterdam UMC 
      location, VU University Medical Center, Amsterdam, The Netherlands.
FAU - Bisschop, Peter H
AU  - Bisschop PH
AD  - Department of Endocrinology and Metabolism, Amsterdam UMC location Academic 
      Medical Center, Amsterdam, The Netherlands.
FAU - Havekes, Bas
AU  - Havekes B
AD  - Department of Internal Medicine, Division of Endocrinology, Maastricht University 
      Medical Center, Maastricht, The Netherlands.
FAU - Borel Rinkes, Inne H M
AU  - Borel Rinkes IHM
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Vriens, Menno R
AU  - Vriens MR
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Valk, Gerlof D
AU  - Valk GD
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The 
      Netherlands.
LA  - eng
GR  - Ipsen Pharmaceutical/
PT  - Journal Article
DEP - 20190810
PL  - United States
TA  - J Surg Oncol
JT  - Journal of surgical oncology
JID - 0222643
RN  - 0 (MEN1 protein, human)
RN  - 0 (Proto-Oncogene Proteins)
RN  - Gastro-enteropancreatic neuroendocrine tumor
SB  - IM
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Gastrinoma/metabolism/*mortality/pathology/surgery
MH  - Humans
MH  - Intestinal Neoplasms/metabolism/*mortality/pathology/surgery
MH  - Liver Neoplasms/metabolism/*mortality/secondary/surgery
MH  - Male
MH  - Middle Aged
MH  - Netherlands
MH  - Neuroendocrine Tumors/metabolism/*mortality/pathology/surgery
MH  - Pancreatic Neoplasms/metabolism/*mortality/pathology/surgery
MH  - Prognosis
MH  - Proto-Oncogene Proteins/*metabolism
MH  - Stomach Neoplasms/metabolism/*mortality/pathology/surgery
MH  - Survival Rate
PMC - PMC6852496
OTO - NOTNLM
OT  - Zollinger-Ellison syndrome
OT  - multiple endocrine neoplasia type 1
OT  - neuroendocrine tumor
OT  - oncology
COIS- There is no conflict of interest that could be perceived as prejudicing the 
      impartiality of the research reported.
EDAT- 2019/08/12 06:00
MHDA- 2019/10/24 06:00
PMCR- 2019/11/13
CRDT- 2019/08/12 06:00
PHST- 2019/07/23 00:00 [received]
PHST- 2019/07/28 00:00 [accepted]
PHST- 2019/08/12 06:00 [pubmed]
PHST- 2019/10/24 06:00 [medline]
PHST- 2019/08/12 06:00 [entrez]
PHST- 2019/11/13 00:00 [pmc-release]
AID - JSO25667 [pii]
AID - 10.1002/jso.25667 [doi]
PST - ppublish
SO  - J Surg Oncol. 2019 Nov;120(6):966-975. doi: 10.1002/jso.25667. Epub 2019 Aug 10.