Determining Prognosis for Patients With Metastatic Grade 1 GEP-NETs

Research from Saneya A. Pandrowala, MBBS, MD, and colleagues published in the Journal of Gastrointestinal Cancer sought to determine the factors that influence survival outcomes in patients with metastatic grade 1 gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

Investigators noted that while GEP-NETs are often torpid, the incidence of patients with GEP-NETs has increased over the last few years. They stated that more research is needed to calculate prognosis.

The retrospective study reviewed the data of 589 patients who received treatment for GEP-NETs from January 2018 to December 2021, with a focus on notable characteristics affecting progression-free survival (PFS). Of the patients, 100 demonstrated grade 1 disease and radiological evidence of distant metastasis.

Eighty-five patients received surgery, 50 underwent treatment with peptide receptor radionuclide therapy, 22 received octreotide LAR, and 4 received chemotherapy.

Dr. Pandrowala and colleagues reported that the median PFS was 54.5 months, with an estimated 3-year PFS of 72.3% and a 3-year overall survival (OS) rate of 93.4%. Following Cox regression, investigators found that the only notable independent predictor of PFS in patients with GEP-NETs was a high liver tumor burden (P=.014).

In patients with concomitant extrahepatic disease, the 5-year OS rate showed a major decrease when compared with patients with liver-limited disease (70.7% vs 100%; P=.017).

“A higher burden of liver disease is associated with shorter PFS in patients with metastatic grade I GEP-NETs,” the researchers wrote. “The OS is significantly lower in patients with associated extrahepatic involvement. These parameters may justify a more aggressive treatment approach in metastatic grade 1 GEP-NETs.”