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. 2017 Jan 11:7:40609.
doi: 10.1038/srep40609.

Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Patricia Freis  1   2   3 , Emmanuelle Graillot  4 , Pascal Rousset  5 , Valérie Hervieu  1 , Laurence Chardon  6 , Catherine Lombard-Bohas  4 , Thomas Walter  2   4
Affiliations

Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Patricia Freis et al. Sci Rep. .

Abstract

Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are a very aggressive type of cancer, for which prognostic factors are lacking. We analysed clinical and histomorphological prognostic markers of overall survival (OS), completed with a record of biological and haematological data of patients diagnosed between December 2002 and December 2015. The median OS was 16 months (95% CI 13.9-18.1). After univariate analysis, performance status (PS) ≥ 2 and stage IV were associated with a worse outcome (9 months and 14 months, respectively), as well as patients with lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) levels ≥ 2 ULN (9 months and 8 months, respectively). After multivariate analysis, LDH and AST levels were the only factors that remained significantly associated with better survival: HR 0.36 (p = 0.04) and 0.31 (p = 0.03), respectively. When patients had elevated LDH and AST levels, OS was 20 months, when they had high LDH or AST levels, 13 months and 8 months in the group with low LDH and AST levels (p < 0.001). Therefore, biological data appeared to be more relevant prognostic factors than usual factors described in other studies (PS, stage, and Ki-67). Considering LDH and AST levels at diagnosis could help physicians to predict survival and to stratify patients for clinical trials.

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Figures

Figure 1
Figure 1
Overall survival (OS) among the population with GEP-NEC (a), and according to serum AST level (b), serum LDH level (c), and combining AST and LDH (d).
See this image and copyright information in PMC

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