Horm Metab Res 2023; 55(12): 827-834
DOI: 10.1055/a-2159-5548
Original Article: Endocrine Care

Bone Metastases in Patients with Pancreatic NETs: Prevalence and Prognosis

Annie Mathew
1   Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany
,
Wolfgang P. Fendler
2   Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
,
Jens Theysohn
3   Institute for Diagnostics and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
,
Ken Herrmann
2   Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
,
Dagmar Führer
1   Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany
,
Harald Lahner
1   Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany
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Abstract

The clinical relevance of bone metastases (BM) in advanced pancreatic neuroendocrine tumors (PanNETs) is poorly described. We analyzed 314 consecutive PanNET patients treated at the European Neuroendocrine Tumour Society (ENETS) Center Essen between 2009 and 2021 in terms of the occurrence and clinical and prognostic impact of BM using hybrid imaging with 68Ga-DOTATOC PET/CT. According to UICC staging, 171/314 (54.5%) patients had stage IV PanNETs. BM was diagnosed in 62/171 (36.3%) patients. Initially, 35% of BMs were visible by pathological tracer uptake only. Skeletal-related events (SREs) were detected in 11 of the 62 patients (17.7%). Patients with antiresorptive therapy had a significantly lower rate of SRE (2/36, 5.6%) than individuals without bone-specific therapy (9/26, 34.6%) (odds ratio 9.0, p=0.0054, Fisher’s exact test). The median overall survival (OS) was 82 months (53.6–110.4, 95% CI) in the stage IV PanNET cohort. The median OS was significantly lower for patients with BM (63 months; 49.9–76.0, 95% CI) than for patients with distant metastases other than BM (116 months; 87.6–144.3, 95% CI) (p=0.016, log-rank test). BM occurs in more than one-third of advanced PanNETs and is associated with an unfavorable prognosis. One in five patients experiences a persistent quality-of-life-lowering SRE. Antiresorptive therapy is associated with a more favorable risk of SREs and should be offered to all patients with BM in PanNETs.

Key words

pancreas - neuroendocrine tumour - bone metastases


Publication History

Received: 02 June 2023

Accepted after revision: 23 August 2023

Accepted Manuscript online:
23 August 2023

Article published online:
01 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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