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10.1038/bjc.2014.468

http://scihub22266oqcxt.onion/10.1038/bjc.2014.468
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suck abstract from ncbi


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pmid25211656
      Br+J+Cancer 2014 ; 111 (9 ): 1703-9
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  • Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality #MMPMID25211656
  • Dobson R ; Burgess MI ; Valle JW ; Pritchard DM ; Vora J ; Wong C ; Chadwick C ; Keevi B ; Adaway J ; Hofmann U ; Poston GJ ; Cuthbertson DJ
  • Br J Cancer 2014[Oct]; 111 (9 ): 1703-9 PMID25211656 show ga
  • BACKGROUND: Carcinoid heart disease is a complication of metastatic neuroendocrine tumours (NETs). We sought to identify factors associated with echocardiographic progression of carcinoid heart disease and death in patients with metastatic NETs. METHODS: Patients with advanced non-pancreatic NETs and documented liver metastases and/or carcinoid syndrome underwent prospective serial clinical, biochemical, echocardiographic and radiological assessment. Patients were categorised as carcinoid heart disease progressors, non-progressors or deceased. Multinomial regression was used to assess the univariate association between variables and carcinoid heart disease progression. RESULTS: One hundred and thirty-seven patients were included. Thirteen patients (9%) were progressors, 95 (69%) non-progressors and 29 (21%) patients deceased. Baseline median levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma 5-hydroxyindoleacetic acid (5-HIAA) were significantly higher in the progressors. Every 100 nmol l(-1) increase in 5-HIAA yielded a 5% greater odds of disease progression (OR 1.05, 95% CI: 1.01, 1.09; P=0.012) and a 7% greater odds of death (OR 1.07, 95% CI: 1.03, 1.10; P=0.001). A 100 ng l(-1) increase in NT-proBNP did not increase the risk of progression, but did increase the risk of death by 11%. CONCLUSIONS: The biochemical burden of disease, in particular baseline plasma 5-HIAA concentration, is independently associated with carcinoid heart disease progression and death. Clinical and radiological factors are less useful prognostic indicators of carcinoid heart disease progression and/or death.
  • |*Echocardiography [MESH]
  • |Aged [MESH]
  • |Carcinoid Heart Disease/*diagnosis/etiology/*mortality [MESH]
  • |Disease Progression [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Liver Neoplasms/*complications/mortality/secondary [MESH]
  • |Male [MESH]
  • |Neoplasm Grading [MESH]
  • |Neuroendocrine Tumors/*complications/mortality/pathology [MESH]
  • |Prognosis [MESH]
  • |Prospective Studies [MESH]


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