ArticleAnnals of surgical oncology2021
It Is Time to Rethink Biomarkers for Surveillance of Small Bowel Neuroendocrine Tumors.
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- NETest2.0Cancers · 2026Article
- Consensus Guideline for the Management of Peritoneal Metastases from Neuroendocrine Neoplasms.Annals of surgical oncology · 2026Article
- Incidence and Survival of Gastro-Entero-Pancreatic Neuroendocrine Neoplasms in the Contemporary Era.JAMA network open · 2026Article
- Longitudinal Changes in Ki-67 Indices in Small-Intestinal Neuroendocrine Tumours and Their Impact on Survival.Neuroendocrinology · 2025Article
- Modified Histopathological Grading Optimizes Prediction of Survival Outcomes in Small Intestinal Neuroendocrine Tumors.The Journal of clinical endocrinology and metabolism · 2024Article
- The Quest for Circulating Biomarkers in Neuroendocrine Neoplasms: a Clinical Perspective.Current treatment options in oncology · 2023Review
- Neuroendocrine hepatic metastatic disease: the surgeon's perspective.Abdominal radiology (New York) · 2022Article
- Circulating Neuroendocrine Tumor Biomarkers: Past, Present and Future.Journal of clinical medicine · 2022Review
- [Liver metastases of neuroendocrine tumors].Chirurgie (Heidelberg, Germany) · 2022Review
- Role of chromogranin A-derived fragments after resection of nonfunctioning pancreatic neuroendocrine tumors.Journal of endocrinological investigation · 2022Article
- Biomarkers in Small Intestine NETs and Carcinoid Heart Disease: A Comprehensive Review.Biology · 2021Review
- Surgical Management of Neuroendocrine Tumor Liver Metastases.Surgical oncology clinics of North America · 2021Review
- Small Bowel Neuroendocrine Tumors.Current problems in surgery · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundTumor biomarkers (TBMs) reflect disease burden and correlate with survival for small bowel neuroendocrine tumors (SBNETs). This study sought to determine the performance of chromogranin A (CgA), pancreastatin (PST), neurokinin A (NKA), and serotonin (5HT) during follow-up assessment of resected SBNETs.
methodsAn institutional database identified patients undergoing surgery for SBNETs. Tumor biomarker levels were assessed as categorical (normal vs elevated) and continuous variables for association with progression-free survival (PFS) and overall survival (OS) via the Kaplan-Meier method with Cox multivariable models adjusted for confounders. Sensitivity, specificity, and predictive values of TBM levels in identifying imaging-confirmed progression were calculated.
resultsIn 218 patients (44% female, 92% node + , 73% metastatic, 97% G1 or G2), higher levels of CgA, PST, NKA, and 5HT correlated with higher-grade and metastatic disease at presentation (p < 0.05). Elevated pre- and postoperative CgA, PST, and NKA correlated with lower PFS and OS (p < 0.05; median follow-up period, 49.6 months). Normal CgA, PST, and NKA were present in respectively 20.3%, 16.9%, and 72.6% of the patients with progression, whereas elevated levels were present in respectively 69.5%, 24.8%, and 1.3% of the patients without progression. Using TBMs to determine progression showed superiority of PST (78.9% accuracy) over CgA (63.3% accuracy) or CgA and PST together (60.3% accuracy).
conclusionAlthough specific for progression, NKA was rarely elevated, limiting its usefulness. Pre- and postoperative PST and CgA correlated with disease burden and survival, with PST providing better discrimination of outcomes. During the follow-up period, use of PST most accurately detected progression. These results suggest that PST should replace CgA for SBNET surveillance.
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