背景:在初次诊断时,胰腺神经内分泌肿瘤(PNETs)患者的远处转移率为20%-50%。然而,肿瘤大小是否可以预测PNETs的远处转移,目前尚不清楚.
方法:我们使用了监测,流行病学,和最终结果(SEER)基于人群的数据,收集2010年至2019年6089例PNETs患者。通过Youden指数计算肿瘤大小预测远处转移的最佳切点。多因素logistic回归分析用于计算肿瘤大小与远处转移模式之间的关联。
结果:最常见的转移部位是肝脏(27.2%),其次是骨骼(3.0%),肺(2.3%)和脑(0.4%)。基于Youden指数确定的肿瘤大小(25.5mm)预测远处转移的最佳临界值,患者分为肿瘤大小<25.5mm和≥25.5mm的组.多因素Logistic回归分析表明,与<25.5毫米相比,肿瘤大小≥25.5mm是总远处转移[比值比(OR)=4.491,95%置信区间(CI):3.724-5.416,P<0.001]和肝转移(OR=4.686,95%CI:3.886-5.651,P<0.001)的独立危险因素.
结论:肿瘤大小≥25.5mm与更多的整体远处转移和肝转移显著相关。对于肿瘤大小≥25.5mm,及时识别远处转移可能为及时和精确的治疗提供生存益处。
BACKGROUND: The rate of distant metastasis in patients with pancreatic neuroendocrine tumors (PNETs) is 20%-50% at the time of initial diagnosis. However, whether tumor size can predict distant metastasis for PNETs remains unknown up to date.
METHODS: We used Surveillance, Epidemiology, and End Results (SEER) population-based data to collect 6089 patients with PNETs from 2010 to 2019. The optimal cut-off point of tumor size to predict distant metastasis was calculated by Youden\'s index. Multivariate logistic regression analysis was used to figure out the association between tumor size and distant metastasis patterns.
RESULTS: The most common metastatic site was liver (27.2%), followed by bone (3.0%), lung (2.3%) and brain (0.4%). Based on an optimal cut-off value of tumor size (25.5 mm) for predicting distant metastasis determined by Youden\'s index, patients were categorized into groups of tumor size < 25.5 mm and ≥ 25.5 mm. Multivariate logistic regression analyses showed that, compared with < 25.5 mm, tumor size ≥ 25.5 mm was an independent risk predictor of overall distant metastasis [odds ratio (OR) = 4.491, 95% confidence interval (CI): 3.724-5.416, P < 0.001] and liver metastasis (OR = 4.686, 95% CI: 3.886-5.651, P < 0.001).
CONCLUSIONS: Tumor size ≥ 25.5 mm was significantly associated with more overall distant and liver metastases. Timely identification of distant metastasis for tumor size ≥ 25.5 mm may provide survival benefit for timely and precise treatment.