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Peritoneal metastases in patients with neuroendocrine neoplasms: a challenging site of metastases with clinical and prognostic implications

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Abstract

Purpose

Peritoneal metastases (PM) of neuroendocrine neoplasm (NEN) origin are identified with increasing frequency and exert a significant effect on quality of life and clinical status of the patients. The aim of this study was to identify the characteristics and the prognostic significance of PM in patients with NENs.

Methods

A retrospective analysis of the data of patients from two tertiary referral centers was performed. We defined a control group of age- and gender-matched NEN patients with comparable stage IV disease but no PM.

Results

We analysed 70 patients (41 females) with PM. Small intestine was the most common primary NEN site (87.1%). PM prevalence was 10.3%. Forty-four patients presented with synchronous PM, whereas 26 developed metachronous PM. The majority of patients had other concomitant metastases (50 hepatic, 6 lung and 12 bone metastases). Twelve patients developed intestinal obstruction. After PM diagnosis, 76% of patients received treatment with somatostatin analogues while six patients (8.6%) were treated with peptide receptor radionuclide therapy (PRRT). The median progression-free survival (PFS) in the PRRT-treated group was 15 months (95% CI 2–28). Median overall survival (OS) in the PM group was 142 months [95% CI 71–213] while it was not reached in the control group.

Conclusion

Peritoneal metastases show low prevalence among NEN patients and are most likely to develop in patients with small intestinal NENs and advanced metastatic disease. The presence of PM does seem to be associated with a negative prognostic impact on OS of NEN patients and their identification and prompt treatment is of major importance.

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Data availability

All data supporting the findings of this study are available upon request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Neuroendocrine Tumour Unit, ENETS Centre of Excellence, 1st Department of Propaedeutic and Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Agiou Thoma 17, 11527, Athens, Greece

    M. Tsoli & G. Kaltsas

  2. Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, NW3 2QG, UK

    H. Wilson, P. Armonis, L. Kamieniarz, J. Thuringer, R. Mirnezami, M. Caplin & C. Toumpanakis

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  1. M. Tsoli
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  2. H. Wilson
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  3. P. Armonis
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Marina Tsoli, Harry Wilson, Panagiotis Armonis, Lucasz Kamieniarz and Jessica Thuringer. The first draft of the manuscript was written by Marina Tsoli and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to M. Tsoli.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was conducted retrospectively from data obtained for clinical purposes and was performed in line with the principles of the Declaration of Helsinki.

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Tsoli, M., Wilson, H., Armonis, P. et al. Peritoneal metastases in patients with neuroendocrine neoplasms: a challenging site of metastases with clinical and prognostic implications. J Endocrinol Invest (2024). https://doi.org/10.1007/s40618-024-02330-5

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