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Pancreatic Neoplasms: HELP
Articles by Staffan Welin
Based on 10 articles published since 2010
(Why 10 articles?)
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Between 2010 and 2020, Staffan Welin wrote the following 10 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Nordic guidelines 2014 for diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms. 2014

Janson, Eva Tiensuu / Sorbye, Halfdan / Welin, Staffan / Federspiel, Birgitte / Grønbæk, Henning / Hellman, Per / Ladekarl, Morten / Langer, Seppo W / Mortensen, Jann / Schalin-Jäntti, Camilla / Sundin, Anders / Sundlöv, Anna / Thiis-Evensen, Espen / Knigge, Ulrich. ·Department of Medical Sciences, Uppsala University , Uppsala , Sweden * ·Acta Oncol · Pubmed #25140861.

ABSTRACT: BACKGROUND: The diagnostic work-up and treatment of patients with neuroendocrine neoplasms (NENs) has undergone major recent advances and new methods are currently introduced into the clinic. An update of the WHO classification has resulted in a new nomenclature dividing NENs into neuroendocrine tumours (NETs) including G1 (Ki67 index ≤ 2%) and G2 (Ki67 index 3-20%) tumours and neuroendocrine carcinomas (NECs) with Ki67 index > 20%, G3. Aim. These Nordic guidelines summarise the Nordic Neuroendocrine Tumour Group's current view on how to diagnose and treat NEN-patients and are meant to be useful in the daily practice for clinicians handling these patients.

2 Guideline Nordic Guidelines 2010 for diagnosis and treatment of gastroenteropancreatic neuroendocrine tumours. 2010

Janson, Eva Tiensuu / Sørbye, Halfdan / Welin, Staffan / Federspiel, Birgitte / Grønbaek, Henning / Hellman, Per / Mathisen, Oystein / Mortensen, Jann / Sundin, Anders / Thiis-Evensen, Espen / Välimäki, Matti J / Oberg, Kjell / Knigge, Ulrich. ·Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Tiensuu_Janson@medsci.uu.se ·Acta Oncol · Pubmed #20553100.

ABSTRACT: The diagnostic work-up and treatment of patients with neuroendocrine tumours has undergone a major change during the last decade. New diagnostic possibilities and treatment options have been developed. These Nordic guidelines, written by a group with a major interest in the subject, summarises our current view on how to diagnose and treat these patients. The guidelines are meant to be useful in the daily practice for clinicians handling patients with neuroendocrine tumours.

3 Review Unmet Needs in Functional and Nonfunctional Pancreatic Neuroendocrine Neoplasms. 2019

Jensen, Robert T / Bodei, Lisa / Capdevila, Jaume / Couvelard, Anne / Falconi, Massimo / Glasberg, Simona / Kloppel, Günter / Lamberts, Steven / Peeters, Marc / Rindi, Guido / Rinke, Anja / Rothmund, Mathias / Sundin, Anders / Welin, Staffan / Fazio, Nicola / Anonymous1371017 / Anonymous1381017. ·Cell Biology Section, NIDDK, National Institutes of Health, Bethesda, Maryland, USArobertj@bdg10.niddk.nih.gov. · Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Department of Medical Oncology, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain. · Service de Pathologie, Hôpital Bichat, Paris, France. · Chirurgia del Pancreas, Università Vita e Salute, San Raffaele Hospital IRCCS, Milan, Italy. · Neuroendocrine Unit, Endocrinology and Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. · Institute of Pathology, Technische Universität München, Munich, Germany. · Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Oncology, Antwerp University Hospital, Edegem, Belgium. · Institute of Anatomic Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. · Department of Gastroenterology, UKGM Marburg and Philipps University, Marburg, Germany. · Department of Surgery, Philipps University, Marburg, Germany. · Department of Radiology, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden. · Endocrine Oncology Unit, Department of Medical Sciences, University Hospital, Uppsala, Sweden. · Gastrointestinal and Neuroendocrine Oncology Unit, European Institute of Oncology (IEO), Milan, Italy. ·Neuroendocrinology · Pubmed #30282083.

ABSTRACT: Recently, the European Neuroendocrine Tumor Society (ENETS) held working sessions composed of members of the advisory board and other neuroendocrine neoplasm (NEN) experts to attempt to identify unmet needs in NENs in different locations or with advanced/poorly differentiated NENs. This report briefly summarizes the main proposed areas of unmet needs in patients with functional and nonfunctional pancreatic NENs.

4 Review Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3). 2019

Sorbye, Halfdan / Baudin, Eric / Borbath, Ivan / Caplin, Martyn / Chen, Jie / Cwikla, Jaroslaw B / Frilling, Andrea / Grossman, Ashley / Kaltsas, Gregory / Scarpa, Aldo / Welin, Staffan / Garcia-Carbonero, Rocio / Anonymous1101017. ·Department of Oncology and Clinical Science, Haukeland University Hospital, Bergen, Norwayhalfdan.sorbye@helse-bergen.no. · Endocrine Oncology, Gustave Roussy, Villejuif, France. · Hepato-Gastroenterology Unit, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium. · Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London, United Kingdom. · Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. · Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland. · Department of Surgery and Cancer, Imperial College London, London, United Kingdom. · Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom. · National and Kapodistrian University of Athens, Athens, Greece. · ARC-Net Centre for Applied Research on Cancer and Section of Pathology of the Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy. · Department of Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden. · Oncology Department, Hospital Universitario 12 de Octubre, CNIO, CIBERONC, Universidad Complutense de Madrid, Madrid, Spain. ·Neuroendocrinology · Pubmed #30153658.

ABSTRACT: Gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are classified based on morphology and graded based on their proliferation rate as either well-differentiated low-grade (G1 to G2) neuroendocrine tumors (NET) or poorly differentiated high-grade (G3) neuroendocrine carcinomas (NEC). Recently, a new subgroup of well-differentiated high-grade pancreatic tumors (NET G3) has been defined. The GEP NEN G3 group consisting of both NEC and NET G3 has recently been shown to be a quite heterogeneous patient group concerning prognosis and treatment benefit, depending on factors such as the primary tumor site, differentiation, proliferation rate, and molecular alterations. In this review we discuss the existing data on diagnostics, treatment, and biomarkers in this patient group, the unmet needs, and the future perspectives.

5 Clinical Trial Five patients with malignant endocrine tumors treated with imatinib mesylate (Glivec). 2010

Kindmark, Henrik / Janson, Eva Tiensuu / Gustavsson, Bengt / Eriksson, Camilla / Larsson, Gunnel / Granberg, Dan / Kozlowacki, Gordana / Skogseid, Britt / Welin, Staffan / Oberg, Kjell / Eriksson, Barbro. ·Department of Medicine/Endocrine Oncology, University Hospital, Uppsala, Sweden. ·Acta Oncol · Pubmed #20100145.

ABSTRACT: -- No abstract --

6 Article Real-world treatment patterns, resource use and costs of treating uncontrolled carcinoid syndrome and carcinoid heart disease: a retrospective Swedish study. 2018

Lesén, Eva / Björstad, Åse / Björholt, Ingela / Marlow, Tom / Bollano, Entela / Feuilly, Marion / Marteau, Florence / Welin, Staffan / Elf, Anna-Karin / Johanson, Viktor. ·a PharmaLex, formerly Nordic Health Economics AB , Gothenburg , Sweden. · b Department of Cardiology , Sahlgrenska University Hospital , Gothenburg , Sweden. · c Ipsen Pharma , Boulogne-Billancourt , France. · d Department of Endocrine Oncology , Uppsala University Hospital , Uppsala , Sweden. · e Department of Surgery , Sahlgrenska University Hospital , Gothenburg , Sweden. ·Scand J Gastroenterol · Pubmed #30449217.

ABSTRACT: OBJECTIVES: To quantify healthcare resource use (HRU) and costs in relation to carcinoid syndrome (CS) and carcinoid heart disease (CHD) in a real-world setting, and to provide perspective on treatment patterns. MATERIALS AND METHODS: Patient data and HRU were collected retrospectively from three Swedish healthcare registers. Adult patients diagnosed with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) grade 1 or 2 and CS who purchased somatostatin analogs (SSAs), and experienced controlled (defined by SSAs use) and uncontrolled (defined by SSAs dose escalation) CS for ≥8 months during the study period were included. Patients diagnosed with CHD from the date of the GEP-NET diagnosis were included in the CHD study group. RESULTS: Overall, total HRU cost increased with uncontrolled CS and CHD. Total resource cost was 15,500€/patient during controlled CS (8 months), rising to 21,700€/patient during uncontrolled CS (8 months), representing an increase of ∼40% (6200€/patient). Costs/patient were driven mainly by SSA use, tumor-related medical interventions and examinations. The total mean cost/year of disease was 1100€/patient without CHD, compared to 4600€/patient with CHD, a difference of 3500€/patient. Excluding SSA cost burden, the main drivers of increased cost in CHD patients were surgical interventions and echocardiography. CONCLUSIONS: This study provides a comprehensive overview of the treatment patterns and burden of uncontrolled CS symptoms and CHD using Swedish national register data. Increases in medical interventions and examinations HRU and increased SSA use suggest that SSA dose escalation alone may not effectively control the symptoms associated with uncontrolled CS, highlighting an unmet treatment need in this patient group.

7 Article Preventive medicine of von Hippel-Lindau disease-associated pancreatic neuroendocrine tumors. 2018

Krauss, Tobias / Ferrara, Alfonso Massimiliano / Links, Thera P / Wellner, Ulrich / Bancos, Irina / Kvachenyuk, Andrey / Villar Gómez de Las Heras, Karina / Yukina, Marina Y / Petrov, Roman / Bullivant, Garrett / von Duecker, Laura / Jadhav, Swati / Ploeckinger, Ursula / Welin, Staffan / Schalin-Jäntti, Camilla / Gimm, Oliver / Pfeifer, Marija / Ngeow, Joanne / Hasse-Lazar, Kornelia / Sansó, Gabriela / Qi, Xiaoping / Ugurlu, M Umit / Diaz, Rene E / Wohllk, Nelson / Peczkowska, Mariola / Aberle, Jens / Lourenço, Delmar M / Pereira, Maria A A / Fragoso, Maria C B V / Hoff, Ana O / Almeida, Madson Q / Violante, Alice H D / Quidute, Ana R P / Zhang, Zhewei / Recasens, Mònica / Díaz, Luis Robles / Kunavisarut, Tada / Wannachalee, Taweesak / Sirinvaravong, Sirinart / Jonasch, Eric / Grozinsky-Glasberg, Simona / Fraenkel, Merav / Beltsevich, Dmitry / Egorov, Viacheslav I / Bausch, Dirk / Schott, Matthias / Tiling, Nikolaus / Pennelli, Gianmaria / Zschiedrich, Stefan / Därr, Roland / Ruf, Juri / Denecke, Timm / Link, Karl-Heinrich / Zovato, Stefania / von Dobschuetz, Ernst / Yaremchuk, Svetlana / Amthauer, Holger / Makay, Özer / Patocs, Attila / Walz, Martin K / Huber, Tobias B / Seufert, Jochen / Hellman, Per / Kim, Raymond H / Kuchinskaya, Ekaterina / Schiavi, Francesca / Malinoc, Angelica / Reisch, Nicole / Jarzab, Barbara / Barontini, Marta / Januszewicz, Andrzej / Shah, Nalini / Young, William F / Opocher, Giuseppe / Eng, Charis / Neumann, Hartmut P H / Bausch, Birke. ·Department of RadiologyMedical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. · Familial Cancer Clinic and OncoendocrinologyVeneto Institute of Oncology IOV- IRCCS, Padua, Italy. · Department of EndocrinologyUniversity of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of SurgeryUniversity of Luebeck, Luebeck, Germany. · Division of EndocrinologyDiabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, USA. · Institute of Endocrinology and MetabolismNAMS of Ukraine, Kiev, Ukraine. · Central ServicesServicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain. · Department of SurgeryEndocrinology Research Center, Moscow, Russia. · Department of SurgeryBakhrushin Brothers Moscow City Hospital, Moscow, Russia. · Princess Margaret Cancer CenterUniversity Health Network, Toronto, Ontario, Canada. · Department of Medicine IVFaculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany. · Department of EndocrinologyKEM Hospital, Mumbai, India. · Interdisciplinary Center of Metabolism: EndocrinologyDiabetes and Metabolism, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany. · Department of Endocrine OncologyUppsala University Hospital, Uppsala, Sweden. · EndocrinologyAbdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. · Department of Clinical and Experimental MedicineDepartment of Surgery, University of Linköping, Linköping, Sweden. · Department of EndocrinologyUniversity Medical Center, Ljubljana, Slovenia. · Cancer Genetics ServiceDivision of Medical Oncology, National Cancer Center Singapore and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. · Department of Endocrine Oncology and Nuclear MedicineCenter of Oncology, MSC Memorial Institute, Gliwice, Poland. · Centro de Investigaciones Endocrinológicas "Dr Cesar Bergada" (CEDIE)Hospital de Niños Ricardo Gutiérrez, CABA, Buenos Aires, Argentina. · Department of Oncologic and Urologic Surgerythe 117th PLA Hospital, Wenzhou Medical University, Hangzhou, Peoples Republic of China. · Department of General SurgeryBreast and Endocrine Surgery Unit, Marmara University School of Medicine, Istanbul, Turkey. · Endocrine SectionHospital del Salvador, Santiago de Chile, Chile. · Department of MedicineEndocrine Section, Hospital del Salvador, University of Chile, Santiago de Chile, Chile. · Department of HypertensionInstitute of Cardiology, Warsaw, Poland. · 3rd Department of MedicineUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Serviço de EndocrinologiaHospital das Clínicas (HCFMUSP) and Instituto do Cancer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. · Serviço de EndocrinologiaHospital das Clinicas (HCFMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. · Department of Internal Medicine-EndocrinologyFaculty of medicine-Hospital Universitario Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. · Department of Physiology and PharmacologyDrug Research and Development Center (NPDM), Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, Brazil. · Department of Urology2nd Hospital of Zhejiang University, School of Medicine, Hangzhou, China. · Hospital Universitari de GironaGerencia Territorial Girona, Institut Català de la Salut, Girona, Spain. · Unidad de Tumores DigestivosServicio de Oncología Médica, Hospital Universitario 12 de Octubre, Madrid, Spain. · Division of Endocrinology and metabolismSiriraj Hospital, Mahidol University, Bangkok, Thailand. · Department of Genitourinary Medical OncologyDivision of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. · Neuroendocrine Tumor DivisionEndocrinology & Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. · Department of EndocrinologyHeinrich-Heine-University, Düsseldorf, Germany. · Department of Medicine (DIMED)Surgical Pathology Unit, University of Padua, Padua, Italy. · Department of Cardiology and Angiology IHeart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany. · Department of Nuclear MedicineFaculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany. · Department of RadiologyCampus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Department of SurgeryAsklepios-Paulinen Klinik, Wiesbaden, Germany. · Section of Endocrine SurgeryReinbek Hospital, Academic Teaching Hospital University of Hamburg, Reinbek, Germany. · Department of Clinical Nuclear MedicineCharité - Universitätsmedizin Berlin, Berlin, Germany. · Department of General SurgeryDivision of Endocrine Surgery, Izmir, Turkey. · 2nd Department of Medicine and Molecular Medicine Research GroupHungarian Academy of Sciences, Semmelweis-University, Budapest, Hungary. · Department of SurgeryHuyssens Foundation Clinics, Essen, Germany. · Department of Medicine IIFaculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany. · Department of Surgical SciencesUppsala University, University Hospital, Uppsala, Sweden. · Department of MedicineUniversity of Toronto, University Healthy Network & Mount Sinai Hospital, The Fred A Litwin Family Center in Genetic Medicine, Toronto, Ontario, Canada. · Department of Clinical Genetics and Department of Clinical and Experimental MedicineLinköping University, Linköping, Sweden. · Department of EndocrinologyLudwigs-Maximilians-University of Munich, Munich, Germany. · Scientific DirectionVeneto Institute of Oncology IOV-IRCCS, Padua, Italy. · Genomic Medicine InstituteLerner Research Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA. · Section for Preventive MedicineFaculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany. · Department of Medicine IIFaculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany birke.bausch@uniklinik-freiburg.de. ·Endocr Relat Cancer · Pubmed #29748190.

ABSTRACT: Pancreatic neuroendocrine tumors (PanNETs) are rare in von Hippel-Lindau disease (VHL) but cause serious morbidity and mortality. Management guidelines for VHL-PanNETs continue to be based on limited evidence, and survival data to guide surgical management are lacking. We established the European-American-Asian-VHL-PanNET-Registry to assess data for risks for metastases, survival and long-term outcomes to provide best management recommendations. Of 2330 VHL patients, 273 had a total of 484 PanNETs. Median age at diagnosis of PanNET was 35 years (range 10-75). Fifty-five (20%) patients had metastatic PanNETs. Metastatic PanNETs were significantly larger (median size 5 vs 2 cm;

8 Article Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3). 2018

Ali, Abir Salwa / Grönberg, Malin / Langer, Seppo W / Ladekarl, Morten / Hjortland, Geir Olav / Vestermark, Lene Weber / Österlund, Pia / Welin, Staffan / Grønbæk, Henning / Knigge, Ulrich / Sorbye, Halfdan / Janson, Eva Tiensuu. ·Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. abir.ali@medsci.uu.se. · Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. · Departments of Surgery C and Endocrinology PE, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. · Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Oslo University Hospital, Oslo, Norway. · Department of Oncology, Odense University Hospital, Odense, Denmark. · Department of Oncology, Tampere University Hospital and Tampere University, Tampere, Finland. · Department of Oncology, Helsinki University Hospital and Helsinki University, Helsinki, Finland. · Departments of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Haukeland University Hospital, Bergen, Norway. ·Med Oncol · Pubmed #29511910.

ABSTRACT: High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs, G3) are aggressive cancers of the digestive system with poor prognosis and survival. Platinum-based chemotherapy (cisplatin/carboplatin + etoposide) is considered the first-line palliative treatment. Etoposide is frequently administered intravenously; however, oral etoposide may be used as an alternative. Concerns for oral etoposide include decreased bioavailability, inter- and intra-patient variability and patient compliance. We aimed to evaluate possible differences in progression-free survival (PFS) and overall survival (OS) in patients treated with oral etoposide compared to etoposide given as infusion. Patients (n = 236) from the Nordic NEC study were divided into three groups receiving etoposide as a long infusion (24 h, n = 170), short infusion (≤ 5 h, n = 33) or oral etoposide (n = 33) according to hospital tradition. PFS and OS were analyzed with Kaplan-Meier (log-rank), cox proportional hazard ratios and confidence intervals. No statistical differences were observed in PFS or OS when comparing patients receiving long infusion (median PFS 3.8 months, median OS 14.5 months), short infusion (PFS 5.6 months, OS 11.0 months) or oral etoposide (PFS 5.4 months, OS 11.3 months). We observed equal efficacy for the three administration routes suggesting oral etoposide may be safe and efficient in treating high-grade GEP-NEN, G3 patients scheduled for cisplatin/carboplatin + etoposide therapy.

9 Article Expression of p53 protein in high-grade gastroenteropancreatic neuroendocrine carcinoma. 2017

Ali, Abir Salwa / Grönberg, Malin / Federspiel, Birgitte / Scoazec, Jean-Yves / Hjortland, Geir Olav / Grønbæk, Henning / Ladekarl, Morten / Langer, Seppo W / Welin, Staffan / Vestermark, Lene Weber / Arola, Johanna / Österlund, Pia / Knigge, Ulrich / Sorbye, Halfdan / Grimelius, Lars / Janson, Eva Tiensuu. ·Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. · Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Biopathology, Institut Gustave Roussy, Villejuif, France. · Department of Oncology, Oslo University, Oslo, Norway. · Department of Hepatology & Gastroenterology, Aarhus university Hospital, Aarhus, Denmark. · Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Oncology, Odense University Hospital, Odense, Denmark. · Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. · Department of Oncology, Helsinki University Hospital and Helsinki University, Helsinki Finland. · Department of Oncology, Tampere University Hospital, Tampere, Finland. · Department of Surgery C and Endocrinology PE, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. · Department of Oncology, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway. · Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. ·PLoS One · Pubmed #29112960.

ABSTRACT: BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs) are aggressive, rapidly proliferating tumors. Therapeutic response to current chemotherapy regimens is usually short lasting. The aim of this study was to examine the expression and potential clinical importance of immunoreactive p53 protein in GEP-NEC. MATERIALS AND METHODS: Tumor tissues from 124 GEP-NEC patients with locally advanced or metastatic disease treated with platinum-based chemotherapy were collected from Nordic centers and clinical data were obtained from the Nordic NEC register. Tumor proliferation rate and differentiation were re-evaluated. All specimens were immunostained for p53 protein using a commercially available monoclonal antibody. Kaplan-Meier curves and cox regression analyses were used to assess progression-free survival (PFS) and overall survival (OS). RESULTS: All tumor tissues were immunoreactive for either one or both neuroendocrine biomarkers (chromogranin A and synaptophysin) and Ki67 index was >20% in all cases. p53 immunoreactivity was only shown in 39% of the cases and was not found to be a prognostic marker for the whole cohort. However, p53 immunoreactivity was correlated with shorter PFS in patients with colorectal tumors (HR = 2.1, p = 0.03) in a univariate analysis as well as to poorer PFS (HR = 2.6, p = 0.03) and OS (HR = 3.4, p = 0.02) in patients with colorectal tumors with distant metastases, a correlation which remained significant in the multivariate analyses. CONCLUSION: In this cohort of GEP-NEC patients, p53 expression could not be correlated with clinical outcome. However, in patients with colorectal NECs, p53 expression was correlated with shorter PFS and OS. Further studies are needed to establish the role of immunoreactive p53 as a prognostic marker for GEP-NEC patients.

10 Article Multiple and Secondary Hormone Secretion in Patients With Metastatic Pancreatic Neuroendocrine Tumours. 2016

Crona, Joakim / Norlén, Olov / Antonodimitrakis, Pantelis / Welin, Staffan / Stålberg, Peter / Eriksson, Barbro. ·Departments of Medical Sciences (J.C., P.A., S.W., B.E.) and Surgical Sciences (O.N., P.S.), Uppsala University, 75185 Uppsala, Sweden. ·J Clin Endocrinol Metab · Pubmed #26672633.

ABSTRACT: CONTEXT: As a group, neuroendocrine tumors (NETs) secrete many different peptide hormones, yet heretofore each NET patient is typically thought to produce at most one hormone that causes a distinct hormonal syndrome. A minority of patients have multiple hormones at diagnosis and may also develop secondary hormone secretion at a later stage. OBJECTIVES: The objectives of the study were to determine the frequency and to describe the impact of multiple and secondary hormone secretion in sporadic gasteroenteropancreatic NET patients. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective analysis of patients (n = 972) with gasteroenteropancreatic NET treated at Uppsala University Hospital, Uppsala, Sweden. Patients with the secretion of multiple hormones at diagnosis and/or those developing secondary hormone secretion during the disease course were identified and studied in further detail. RESULTS: In pancreatic NETs (PNETs), a total of 19 of 323 patients (6%) had secretion of multiple hormones at diagnosis, and 14 of 323 (4%) had secondary changes during the disease course. These phenomena occurred exclusively in patients with an advanced disease stage, and secondary hormones were detected in a close time span with progressive disease. Patients with secondary insulin hypersecretion had increased morbidity as well as reduced survival (P < .002). In contrast, multiple and secondary hormone secretion was rarely seen in NETs of the small intestine with 0 and 1 of 603 cases, respectively. CONCLUSION: Diversity of PNET hormone secretion either at diagnosis or during the disease course occurred in a minority of patients (9.3%). These phenomena had a major impact on patient outcome both through increased morbidity and mortality. Our results support that patients with metastatic PNETs should be monitored for clinical symptoms of secondary hormone secretion during the disease course.