Biomarkers predict outcomes following cytoreductive surgery for hepatic metastases from functional carcinoid tumors

Eric H. Jensen, Larry Kvols, James Mcloughlin, James Lewis, Michael D. Alvarado, Timothy Yeatman, Mokenge Malafa, David Shibata

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: Cytoreductive therapy for metastatic carcinoid provides symptomatic relief and improvement in overall survival. We evaluated whether CgA and 5HIAA could predict symptomatic relief and control of disease progression after cytoreductive surgery. Methods: We retrospectively reviewed 70 patients who underwent cytoreductive surgery for neuroendocrine hepatic metastases between 1996 and 2005. Twenty-two patients had pre and post-operative CgA and/or 5HIAA levels measured. Reduction of biomarkers following cytoreduction was correlated with patient symptoms and progression of disease following surgery. Results: Our study consisted of 14 males and 8 females with a mean age of 55 (±12 years). Median follow-up was 18 months (range 5-64 months). Six patients (26.1%) had complete (R0) cytoreduction, while 4 (17.4%) and 13 (56.5%) had microscopic (R1) and gross (R2) disease remaining. All patients reported improvements in their symptoms, with 12 (54.5%) reporting complete resolution (CR) and 10 (45.5%) reporting partial resolution (PR). Reduction of CgA of ≥ 80% was highly predictive of complete resolution of symptoms (P = 0.007) and stabilization of disease (P = 0.034). Reduction of 5HIAA levels of ≥ 80% (or normalization) was predictive of symptomatic relief, but not progression of disease (P = 0.026 and P = 0.725). Five of six patients who had R0 resections had CR and were free of disease at last follow-up (median 24.5 months, range: 11-48, P = 0.002). Conclusions: We conclude that ≥ 80% reduction in CgA level following cytoreductive surgery for carcinoid tumors is predictive of subsequent symptom relief and disease control. Substantial reduction in CgA is associated with improved patient outcomes, even after incomplete cytoreduction.

Original languageEnglish (US)
Pages (from-to)780-785
Number of pages6
JournalAnnals of Surgical Oncology
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2007

Fingerprint

Carcinoid Tumor
Biomarkers
Neoplasm Metastasis
Liver
Disease Progression
Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Biomarkers predict outcomes following cytoreductive surgery for hepatic metastases from functional carcinoid tumors. / Jensen, Eric H.; Kvols, Larry; Mcloughlin, James; Lewis, James; Alvarado, Michael D.; Yeatman, Timothy; Malafa, Mokenge; Shibata, David.

In: Annals of Surgical Oncology, Vol. 14, No. 2, 01.02.2007, p. 780-785.

Research output: Contribution to journalArticle

Jensen, Eric H. ; Kvols, Larry ; Mcloughlin, James ; Lewis, James ; Alvarado, Michael D. ; Yeatman, Timothy ; Malafa, Mokenge ; Shibata, David. / Biomarkers predict outcomes following cytoreductive surgery for hepatic metastases from functional carcinoid tumors. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 2. pp. 780-785.
@article{b8d98feeeb214a459919da3c3d258ac3,
title = "Biomarkers predict outcomes following cytoreductive surgery for hepatic metastases from functional carcinoid tumors",
abstract = "Background: Cytoreductive therapy for metastatic carcinoid provides symptomatic relief and improvement in overall survival. We evaluated whether CgA and 5HIAA could predict symptomatic relief and control of disease progression after cytoreductive surgery. Methods: We retrospectively reviewed 70 patients who underwent cytoreductive surgery for neuroendocrine hepatic metastases between 1996 and 2005. Twenty-two patients had pre and post-operative CgA and/or 5HIAA levels measured. Reduction of biomarkers following cytoreduction was correlated with patient symptoms and progression of disease following surgery. Results: Our study consisted of 14 males and 8 females with a mean age of 55 (±12 years). Median follow-up was 18 months (range 5-64 months). Six patients (26.1{\%}) had complete (R0) cytoreduction, while 4 (17.4{\%}) and 13 (56.5{\%}) had microscopic (R1) and gross (R2) disease remaining. All patients reported improvements in their symptoms, with 12 (54.5{\%}) reporting complete resolution (CR) and 10 (45.5{\%}) reporting partial resolution (PR). Reduction of CgA of ≥ 80{\%} was highly predictive of complete resolution of symptoms (P = 0.007) and stabilization of disease (P = 0.034). Reduction of 5HIAA levels of ≥ 80{\%} (or normalization) was predictive of symptomatic relief, but not progression of disease (P = 0.026 and P = 0.725). Five of six patients who had R0 resections had CR and were free of disease at last follow-up (median 24.5 months, range: 11-48, P = 0.002). Conclusions: We conclude that ≥ 80{\%} reduction in CgA level following cytoreductive surgery for carcinoid tumors is predictive of subsequent symptom relief and disease control. Substantial reduction in CgA is associated with improved patient outcomes, even after incomplete cytoreduction.",
author = "Jensen, {Eric H.} and Larry Kvols and James Mcloughlin and James Lewis and Alvarado, {Michael D.} and Timothy Yeatman and Mokenge Malafa and David Shibata",
year = "2007",
month = "2",
day = "1",
doi = "10.1245/s10434-006-9148-z",
language = "English (US)",
volume = "14",
pages = "780--785",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Biomarkers predict outcomes following cytoreductive surgery for hepatic metastases from functional carcinoid tumors

AU - Jensen, Eric H.

AU - Kvols, Larry

AU - Mcloughlin, James

AU - Lewis, James

AU - Alvarado, Michael D.

AU - Yeatman, Timothy

AU - Malafa, Mokenge

AU - Shibata, David

PY - 2007/2/1

Y1 - 2007/2/1

N2 - Background: Cytoreductive therapy for metastatic carcinoid provides symptomatic relief and improvement in overall survival. We evaluated whether CgA and 5HIAA could predict symptomatic relief and control of disease progression after cytoreductive surgery. Methods: We retrospectively reviewed 70 patients who underwent cytoreductive surgery for neuroendocrine hepatic metastases between 1996 and 2005. Twenty-two patients had pre and post-operative CgA and/or 5HIAA levels measured. Reduction of biomarkers following cytoreduction was correlated with patient symptoms and progression of disease following surgery. Results: Our study consisted of 14 males and 8 females with a mean age of 55 (±12 years). Median follow-up was 18 months (range 5-64 months). Six patients (26.1%) had complete (R0) cytoreduction, while 4 (17.4%) and 13 (56.5%) had microscopic (R1) and gross (R2) disease remaining. All patients reported improvements in their symptoms, with 12 (54.5%) reporting complete resolution (CR) and 10 (45.5%) reporting partial resolution (PR). Reduction of CgA of ≥ 80% was highly predictive of complete resolution of symptoms (P = 0.007) and stabilization of disease (P = 0.034). Reduction of 5HIAA levels of ≥ 80% (or normalization) was predictive of symptomatic relief, but not progression of disease (P = 0.026 and P = 0.725). Five of six patients who had R0 resections had CR and were free of disease at last follow-up (median 24.5 months, range: 11-48, P = 0.002). Conclusions: We conclude that ≥ 80% reduction in CgA level following cytoreductive surgery for carcinoid tumors is predictive of subsequent symptom relief and disease control. Substantial reduction in CgA is associated with improved patient outcomes, even after incomplete cytoreduction.

AB - Background: Cytoreductive therapy for metastatic carcinoid provides symptomatic relief and improvement in overall survival. We evaluated whether CgA and 5HIAA could predict symptomatic relief and control of disease progression after cytoreductive surgery. Methods: We retrospectively reviewed 70 patients who underwent cytoreductive surgery for neuroendocrine hepatic metastases between 1996 and 2005. Twenty-two patients had pre and post-operative CgA and/or 5HIAA levels measured. Reduction of biomarkers following cytoreduction was correlated with patient symptoms and progression of disease following surgery. Results: Our study consisted of 14 males and 8 females with a mean age of 55 (±12 years). Median follow-up was 18 months (range 5-64 months). Six patients (26.1%) had complete (R0) cytoreduction, while 4 (17.4%) and 13 (56.5%) had microscopic (R1) and gross (R2) disease remaining. All patients reported improvements in their symptoms, with 12 (54.5%) reporting complete resolution (CR) and 10 (45.5%) reporting partial resolution (PR). Reduction of CgA of ≥ 80% was highly predictive of complete resolution of symptoms (P = 0.007) and stabilization of disease (P = 0.034). Reduction of 5HIAA levels of ≥ 80% (or normalization) was predictive of symptomatic relief, but not progression of disease (P = 0.026 and P = 0.725). Five of six patients who had R0 resections had CR and were free of disease at last follow-up (median 24.5 months, range: 11-48, P = 0.002). Conclusions: We conclude that ≥ 80% reduction in CgA level following cytoreductive surgery for carcinoid tumors is predictive of subsequent symptom relief and disease control. Substantial reduction in CgA is associated with improved patient outcomes, even after incomplete cytoreduction.

UR - http://www.scopus.com/inward/record.url?scp=33846577777&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846577777&partnerID=8YFLogxK

U2 - 10.1245/s10434-006-9148-z

DO - 10.1245/s10434-006-9148-z

M3 - Article

VL - 14

SP - 780

EP - 785

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 2

ER -