In:
Neuroendocrinology, S. Karger AG, Vol. 111, No. 9 ( 2021), p. 831-839
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 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 (TGR 〈 sub 〉 3m 〈 /sub 〉 ) as a predictor factor of progression-free survival (PFS), including the impact of imaging method and reader variability. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 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 TGR 〈 sub 〉 3m 〈 /sub 〉 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). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 790 lesions were measured in 222 patients. Median PFS was 22.9 months. On univariable analysis, number of lesions ( & #x3c;/≥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]), TGR 〈 sub 〉 3m 〈 /sub 〉 ≥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 TGR 〈 sub 〉 3m 〈 /sub 〉 and number of lesions (rho: −0.2; 〈 i 〉 p 〈 /i 〉 value: 0.1930). No difference in mean TGR 〈 sub 〉 3m 〈 /sub 〉 across organs was shown ( 〈 i 〉 p 〈 /i 〉 value: 0.6). Concordance between readers was acceptable (LCC: 0.52 [95% CI: 0.38–0.65]; KC: 0.57, agreement: 81.55%). TGR 〈 sub 〉 3m 〈 /sub 〉 remained a significant prognostic factor when data from the second reader were employed (HR: 4.35 [95% CI: 2.44–7.79]; 〈 i 〉 p 〈 /i 〉 value & #x3c;0.001) regardless his expertise (HR: 1.21 [95% CI: 0.70–2.09]; 〈 i 〉 p 〈 /i 〉 value: 0.493). 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 TGR 〈 sub 〉 3m 〈 /sub 〉 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.
Type of Medium:
Online Resource
ISSN:
0028-3835
,
1423-0194
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
123303-8
detail.hit.zdb_id:
1483028-0
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