Tumor Growth Rate to Predict the Outcome of Patients with Neuroendocrine Tumors: Performance and Sources of Variability.

Details

Serval ID
serval:BIB_08CA4B4D3DF5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Tumor Growth Rate to Predict the Outcome of Patients with Neuroendocrine Tumors: Performance and Sources of Variability.
Journal
Neuroendocrinology
Author(s)
Dromain C., Sundin A., Najran P., Vidal Trueba H., Dioguardi Burgio M., Crona J., Opalinska M., Carvalho L., Franca R., Borg P., Vietti Violi N., Schaefer N., Lopez C., Pezzutti D., de Mestier L., Lamarca A., Costa F., Pavel M., Ronot M.
ISSN
1423-0194 (Electronic)
ISSN-L
0028-3835
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
111
Number
9
Pages
831-839
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Tumor growth rate (TGR), percentage of change in tumor volume/month, has been previously identified as an early radiological biomarker for treatment monitoring in neuroendocrine tumor (NET) patients. We assessed the performance and reproducibility of TGR at 3 months (TGR3m) as a predictor factor of progression-free survival (PFS), including the impact of imaging method and reader variability.
Baseline and 3-month (±1 month) CT/MRI images from patients with advanced, grade 1-2 NETs were retrospectively reviewed by 2 readers. Influence of number of targets, tumor burden, and location of lesion on the performance of TGR3m to predict PFS was assessed by uni/multivariable Cox regression analysis. Agreement between readers was assessed by Lin's concordance coefficient (LCC) and kappa coefficient (KC).
A total of 790 lesions were measured in 222 patients. Median PFS was 22.9 months. On univariable analysis, number of lesions (</≥4), tumor burden, and presence of liver metastases were significantly correlated with PFS. On multivariate analysis, ≥4 lesions (HR: 1.89 [95% CI: 1.01-3.57]), TGR3m ≥0.8%/month (HR: 4.01 [95% CI: 2.31-6.97]), and watch and wait correlated with shorter PFS. No correlation was found between TGR3m and number of lesions (rho: -0.2; p value: 0.1930). No difference in mean TGR3m across organs was shown (p value: 0.6). Concordance between readers was acceptable (LCC: 0.52 [95% CI: 0.38-0.65]; KC: 0.57, agreement: 81.55%). TGR3m remained a significant prognostic factor when data from the second reader were employed (HR: 4.35 [95% CI: 2.44-7.79]; p value <0.001) regardless his expertise (HR: 1.21 [95% CI: 0.70-2.09]; p value: 0.493).
TGR3m is a robust and early radiological biomarker able to predict PFS. It may be used to identify patients with advanced NETs who require closer radiological follow-up.
Keywords
Biomarkers, Neuroendocrine tumors, Prognosis, Reproducibility of results
Pubmed
Web of science
Create date
28/07/2020 9:28
Last modification date
04/09/2021 6:34
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