Elevated Alkaline Phosphatase Prior to Transarterial Chemoembolization for Neuroendocrine Tumors Predicts Worse Outcomes View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-03

AUTHORS

Jill K. Onesti, Lawrence A. Shirley, Neil D. Saunders, Gail W. Davidson, Mary E. Dillhoff, Hooman Khabiri, Gregory E. Guy, Joshua D. Dowell, Carl R Schmidt, Manisha H. Shah, Mark Bloomston

ABSTRACT

INTRODUCTION: We hypothesized that an elevated preoperative alkaline phosphatase (AP) predicted worse outcomes for patients undergoing transarterial chemoembolization (TACE) for neuroendocrine tumor (NET) liver metastases. METHODS: We reviewed all patients who underwent TACE for metastatic NET between 2009 and 2013. Survival was evaluated using preprocedure variables. RESULTS: One hundred and nine patients underwent 210 TACE procedures. The average age was 57.7 years (range 20-78). Primary sites included pancreas (N = 20), other gastrointestinal (N = 52), lung (N = 9), and unknown (N = 28). The tumor was grade 1 in 68 (62 %), grade 2 in 21 (19 %), and grade 3 in 3 (3 %). Extrahepatic disease was present in 54 (50 %) and greater than 50 % hepatic tumor burden by imaging in 63 (58 %). Elevated bilirubin occurred in 8 (7 %), elevated AP in 22 (20 %), elevated ALT in 21 (19 %), and elevated AST in 41 (38 %). Univariate predictors included tumor grade (43 vs 27 vs 21 months, p = 0.015), hepatic tumor burden (59 vs 37 months, p = 0.009), and elevated AP (59 vs 23 months, p < 0.001). On multivariate analysis, only elevated AP (p = 0.001) predicted worse survival. CONCLUSIONS: Elevated AP prior to TACE for metastatic NET portends a worse survival outcome, even more so than tumor grade or extent of hepatic disease. More... »

PAGES

580-586

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-015-2998-6

DOI

http://dx.doi.org/10.1007/s11605-015-2998-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1045635469

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26489743


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Turtle is a human-readable linked data format.

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RDF/XML is a standard XML format for linked data.

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