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Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors

Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–201...

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Autores principales: Stensbøl, Anna Bryan, Krogh, Jesper, Holmager, Pernille, Klose, Marianne, Oturai, Peter, Kjaer, Andreas, Hansen, Carsten Palnæs, Federspiel, Birgitte, Langer, Seppo W., Knigge, Ulrich, Andreassen, Mikkel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624499/
https://www.ncbi.nlm.nih.gov/pubmed/34829377
http://dx.doi.org/10.3390/diagnostics11112030
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author Stensbøl, Anna Bryan
Krogh, Jesper
Holmager, Pernille
Klose, Marianne
Oturai, Peter
Kjaer, Andreas
Hansen, Carsten Palnæs
Federspiel, Birgitte
Langer, Seppo W.
Knigge, Ulrich
Andreassen, Mikkel
author_facet Stensbøl, Anna Bryan
Krogh, Jesper
Holmager, Pernille
Klose, Marianne
Oturai, Peter
Kjaer, Andreas
Hansen, Carsten Palnæs
Federspiel, Birgitte
Langer, Seppo W.
Knigge, Ulrich
Andreassen, Mikkel
author_sort Stensbøl, Anna Bryan
collection PubMed
description Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–2011 vs. 2019–2020), (2) changes in the initial indication for diagnostic workup and 3) the differences in stage between incidentally discovered vs. symptomatic disease during the entire study period. Methods: We performed a retrospective study, that includes consecutive siNET and pNET patients referred to the Copenhagen ENETS center of excellence in 2010–2011 and 2019–2020. Results: The annual incidence of siNET per 100,000 increased from 1.39 to 1.84, (p = 0.05). There was no change in the stage at diagnosis, and in both periods approximately 30% of patients were incidentally diagnosed (p = 0.62). Dissemination was found in 72/121 (60%) of symptomatic vs. 22/50 (44%) of incidentally discovered SI tumors in the entire cohort, (p = 0.06). The annual incidence of pNET increased from 0.42 to 1.39 per 100,000, (p < 0.001). The proportion of patients with disseminated disease decreased from 8/21 (38%) to 12/75 (16%), (p = 0.02) and the number of incidental findings increased from 4/21 (19%) to 43/75 (57%), (p = 0.002). More symptomatic patients had disseminated disease compared to patients with incidentally discovered tumors (15/49 (31%) vs. 5/47 (11%), (p = 0.01)). Conclusion: The incidence of siNET and pNETs increased over the past decade. For siNETs, the stage of disease and the distribution of symptomatic vs. incidentally discovered tumors were unchanged between the two periods. Patients with pNETs presented with more local and incidentally discovered tumors in the latter period. Patients with incidentally discovered siNETs had disseminated disease in 44% of the overall cases. The vast majority of incidentally found pNETs were localized.
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spelling pubmed-86244992021-11-27 Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors Stensbøl, Anna Bryan Krogh, Jesper Holmager, Pernille Klose, Marianne Oturai, Peter Kjaer, Andreas Hansen, Carsten Palnæs Federspiel, Birgitte Langer, Seppo W. Knigge, Ulrich Andreassen, Mikkel Diagnostics (Basel) Article Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–2011 vs. 2019–2020), (2) changes in the initial indication for diagnostic workup and 3) the differences in stage between incidentally discovered vs. symptomatic disease during the entire study period. Methods: We performed a retrospective study, that includes consecutive siNET and pNET patients referred to the Copenhagen ENETS center of excellence in 2010–2011 and 2019–2020. Results: The annual incidence of siNET per 100,000 increased from 1.39 to 1.84, (p = 0.05). There was no change in the stage at diagnosis, and in both periods approximately 30% of patients were incidentally diagnosed (p = 0.62). Dissemination was found in 72/121 (60%) of symptomatic vs. 22/50 (44%) of incidentally discovered SI tumors in the entire cohort, (p = 0.06). The annual incidence of pNET increased from 0.42 to 1.39 per 100,000, (p < 0.001). The proportion of patients with disseminated disease decreased from 8/21 (38%) to 12/75 (16%), (p = 0.02) and the number of incidental findings increased from 4/21 (19%) to 43/75 (57%), (p = 0.002). More symptomatic patients had disseminated disease compared to patients with incidentally discovered tumors (15/49 (31%) vs. 5/47 (11%), (p = 0.01)). Conclusion: The incidence of siNET and pNETs increased over the past decade. For siNETs, the stage of disease and the distribution of symptomatic vs. incidentally discovered tumors were unchanged between the two periods. Patients with pNETs presented with more local and incidentally discovered tumors in the latter period. Patients with incidentally discovered siNETs had disseminated disease in 44% of the overall cases. The vast majority of incidentally found pNETs were localized. MDPI 2021-11-03 /pmc/articles/PMC8624499/ /pubmed/34829377 http://dx.doi.org/10.3390/diagnostics11112030 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Stensbøl, Anna Bryan
Krogh, Jesper
Holmager, Pernille
Klose, Marianne
Oturai, Peter
Kjaer, Andreas
Hansen, Carsten Palnæs
Federspiel, Birgitte
Langer, Seppo W.
Knigge, Ulrich
Andreassen, Mikkel
Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_full Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_fullStr Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_full_unstemmed Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_short Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_sort incidence, clinical presentation and trends in indication for diagnostic work-up of small intestinal and pancreatic neuroendocrine tumors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624499/
https://www.ncbi.nlm.nih.gov/pubmed/34829377
http://dx.doi.org/10.3390/diagnostics11112030
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