Abstract
There are scarce data on readily available markers enabling immediate risk stratification
and personalized management in patients with advanced pancreatic neuroendocrine tumors.
This study explores the association of red blood cells-related parameters as prognostic
markers in patients harboring pancreatic neuroendocrine tumors. Retrospective analysis
of a tertiary medical center database, acquiring data of patients with pancreatic
neuroendocrine tumors including demographics, tumor-related parameters and consecutive
imaging results, vital status at last follow-up, and red blood cells parameters at
baseline, last follow-up, and dynamics (last/baseline ratio). Univariate and multivariable
analyses were performed. Sixty-seven patients were identified (mean age at diagnosis
of 63±11 years, 56.7% males). Patients with disease progression had lower hemoglobin,
red blood cells mass values and hematocrit at the last evaluation (p<0.001 for all
comparisons), with red blood cells mass level<3.9 m/μl and a 6% and 9% relative reduction
in hemoglobin and hematocrit levels, respectively, associated with an increased risk
for disease progression. Similarly, patients deceased during the study period had
lower hemoglobin, red blood cells mass values and hematocrit (p<0.03 for all) than
those alive, at last follow-up. Eleven percent reduction in hemoglobin level was noted
indicating a higher mortality risk (p=0.04). Negative hemoglobin and hematocrit dynamics
were independently associated with increased risk for disease progression (p=0.03
and 0.049, respectively). In conclusion, decrease in red blood cells mass, hemoglobin
and/or hematocrit levels are all associated with poor prognosis in patients with pancreatic
neuroendocrine tumors. We suggest utilizing these parameters as complementary follow-up
prognostic markers to radiologic imaging in this patients population.
Key words
prognosis - mortality - hematocrit - neuroendocrine tumor - pancreas - hemoglobin
