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Poster display session

4626 - Bone metastases in patients with neuroendocrine neoplasms: a survey of natural history and clinical management

Date

10 Sep 2017

Session

Poster display session

Presenters

Nicola Fazio

Citation

Annals of Oncology (2017) 28 (suppl_5): v142-v157. 10.1093/annonc/mdx368

Authors

N. Fazio1, P. Maisonneuve2, A.M. Frezza3, T. Ibrahim4, A. La Salvia5, S. Tafuto6, S. Pusceddu7, R. Marconcini8, F. Silvestris9, D. Campana10, D. Santini11, A. Faggiano12, S. Massironi13, L. De Marinis14, G. Rubini15, E. Merola16, L. Antonuzzo17, V. Amoroso18, I. Puliafito19, F. Spada1

Author affiliations

  • 1 Unit Of Gastrointestinal Medical Oncology And Neuroendocrine Tumors, European Institute of Oncology, 20141 - Milan/IT
  • 2 Epidemiology, European Institute of Oncology, Milan/IT
  • 3 Adult Mesenchymal Tumour And Rare Cancer Medical Oncology Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 4 Osteoncology And Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola/IT
  • 5 Oncologia Medica, Ospedale S. Luigi, Orbassano/IT
  • 6 Medical Oncology, Istituto Nazionale Tumori – I.R.C.C.S - Fondazione Pascale, 80131 - Napoli/IT
  • 7 Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 8 Oncology Department, Azienda Ospedaliera Universitaria S.Chiara, 56100 - Pisa/IT
  • 9 Sicenze Biomediche Ed Oncologia Umana, Università di Bari, Bari/IT
  • 10 Oncologia Medica, Policlinico S. Orsola, Bologna/IT
  • 11 Department Of Oncology, Campus Bio-Medico di Roma, 128 - Roma/IT
  • 12 Endocrinologia, Policlinico di Napoli, Naples/IT
  • 13 Gastroenterologia, Policlinico, Milan/IT
  • 14 Endocrinologia, Policlinico Gemelli, Rome/IT
  • 15 Medicina Nucleare, Università di Bari, Bari/IT
  • 16 Gastroenterologia, Ospedale S Andrea, Roma/IT
  • 17 Medical Oncology, Azienda Ospedaliera Careggi, 50139 - Firenze/IT
  • 18 Oncologia Medica, Spedali Civili, Brescia/IT
  • 19 Oncologia Medica, Istituto Oncologico del Mediterraneo, Viagrande/IT
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Resources

Abstract 4626

Background

Bone metastases (BM) in neuroendocrine neoplasms (NEN) represent a poorly defined issue.

Methods

This is a nationwide survey among Italian institutions dealing with NEN patients. Characteristics of BM, clinical management, skeletal related events (SREs) and disease outcome were recorded.

Results

We analysed 321 patients with histological diagnosis of NEN and BM collected from 18 Italian Centers. Mean age was 59 y.o. (range 13-86). Primary sites were 47% gastroenteropancreatic (GEP), 36% lung, 4% Paraganglioma/Pheocromocytoma (Par/Pheo), 7% unknown, 5% others. The vast majority (72%) of NEN were already metastatic at diagnosis and the liver represented the second most frequent site of metastasis (in 77% of patients) during follow-up, in addition to BM. Bone was the first metastatic site in 41% of cases. Neoplasms were low/intermediate grade in 80% and high grade in 20%. SREs occurred in 32% of cases, mainly in lung and others. Median time to SRE was 4 months. It strictly correlated with the high grade, irrespective of the primary site. Bisphosphonates were administered in 32% of patients. Median survival from BM diagnosis was 65 months (range 45-78) in the whole population, with Par/Pheo at the best and high grade GEP at the worst limit. SRE, high grade (or in alternative high Ki-67) and prior lung metastases resulted significantly associated with worse overall survival at the multivariable analysis. After adjustment for tumor grade, survival of patients with GEP and lung NENs were similar.

Conclusions

This is one of the largest series of NEN patients with BM reported so far. This survey mirrors the Italian real clinical practice in this setting, as it included most Centers involved in NET patients’ management. It showed that overall, BM from NEN are associated with a relatively long survival. Bisphosphonates were used in a low percentage of cases, probably related to SRE. Tumor grade confirmed its value in separating two survival categories, irrespective of primary site. The results of this analysis generated hypotheses for prospective trials in homogeneous clinical settings.

Clinical trial identification

Legal entity responsible for the study

Nicola Fazio

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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