TY - JOUR
T1 - Prognostic value of CT characteristics in GEP-NET
T2 - A systematic review
AU - van der Velden, D. L.
AU - Staal, F. C. R.
AU - Aalbersberg, E. A.
AU - Castagnoli, F.
AU - Wilthagen, E.
AU - Beets-Tan, R. G. H.
N1 - Publisher Copyright: © 2022 Elsevier B.V.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Aim: A range of CT characteristics with potential prognostic value have previously been identified for gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). Still, there is no widely accepted consensus on which characteristics should be reported as prognostic factors. This systematic review therefore aims to provide an overview of the available literature regarding CT characteristics and their prognostic significance for GEP-NET patients. Materials and methods: PubMed, Embase, and Scopus/Cochrane Library databases were searched and a forward and backward reference check of the identified studies was executed. Eligible studies were conducted in patients with GEP-NET, and reported on the prognostic significance (in terms of tumor grade, spread of disease, and survival) of CT-based biomarkers. Study selection, quality assessment and data extraction were performed by two reviewers independently, resolving disagreement by consensus. Results: In total, 5074 unique studies were identified, of which 37 were included. Given the paucity of data on GEP-NETs other than PNET, data extraction and analyses was restricted to PNETs. Fourteen CT characteristics were correlated to prognostic outcomes. Larger tumor size, hypo-enhancement, irregular shape and ill-defined margins, presence of locally invasive growth, lymphadenopathy and metastases were predictors of poorer prognosis according to 65–89% of the available studies. Most studies were regarded as having a low (65%) or moderate (24%) risk of bias. Conclusion: Evidence regarding prognostic value of CT-based biomarkers for PNETs is limited to heterogeneous, retrospective studies. Nonetheless, heterogeneity in data is more likely to obscure than to overestimate any correlation. Therefore, we feel that the before-mentioned characteristics should be regarded and reported as clinically relevant predictors of poorer prognosis.
AB - Aim: A range of CT characteristics with potential prognostic value have previously been identified for gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). Still, there is no widely accepted consensus on which characteristics should be reported as prognostic factors. This systematic review therefore aims to provide an overview of the available literature regarding CT characteristics and their prognostic significance for GEP-NET patients. Materials and methods: PubMed, Embase, and Scopus/Cochrane Library databases were searched and a forward and backward reference check of the identified studies was executed. Eligible studies were conducted in patients with GEP-NET, and reported on the prognostic significance (in terms of tumor grade, spread of disease, and survival) of CT-based biomarkers. Study selection, quality assessment and data extraction were performed by two reviewers independently, resolving disagreement by consensus. Results: In total, 5074 unique studies were identified, of which 37 were included. Given the paucity of data on GEP-NETs other than PNET, data extraction and analyses was restricted to PNETs. Fourteen CT characteristics were correlated to prognostic outcomes. Larger tumor size, hypo-enhancement, irregular shape and ill-defined margins, presence of locally invasive growth, lymphadenopathy and metastases were predictors of poorer prognosis according to 65–89% of the available studies. Most studies were regarded as having a low (65%) or moderate (24%) risk of bias. Conclusion: Evidence regarding prognostic value of CT-based biomarkers for PNETs is limited to heterogeneous, retrospective studies. Nonetheless, heterogeneity in data is more likely to obscure than to overestimate any correlation. Therefore, we feel that the before-mentioned characteristics should be regarded and reported as clinically relevant predictors of poorer prognosis.
KW - Computed tomography
KW - Follow up
KW - GEP-NET
KW - Imaging
KW - Neuroendocrine tumor
KW - Prognostic biomarkers
KW - Survival
KW - Tumor grade
UR - http://www.scopus.com/inward/record.url?scp=85130850617&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.critrevonc.2022.103713
DO - https://doi.org/10.1016/j.critrevonc.2022.103713
M3 - Review article
C2 - 35598829
SN - 1040-8428
VL - 175
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
M1 - 103713
ER -