Accessible prognostic tools are needed to individualize treatment of neuroendocrine tumors (NETs). Data suggest neutrophil/lymphocyte ratios (NLRs) have prognostic value in some solid tumors, including NETs. In the randomized double-blind CLARINET study (NCT00353496; EudraCT 2005-004904-35), the somatostatin analog lanreotide autogel/depot increased progression-free survival (PFS) compared with placebo in patients with inoperable or metastatic intestinal and pancreatic NETs (grades 1-2, Ki-67 < 10%). The exploratory post-hoc analyses presented here evaluated the prognostic value of NLR in the CLARINET study cohort, in the context of and independently from treatment. Kaplan-Meier PFS plots were generated for patients with available NLR data, in subgroups based on NLR values, and 24-month survival rates were calculated. P values and hazard ratios for prognostic effects were generated using Cox models. 31216222 Baseline characteristics were balanced between lanreotide autogel/depot 120 mg (n = 100) and placebo (n = 101) arms. Irrespective of treatment, raw 24-month PFS rates were comparable across subgroups based on NLR tertiles [37.3% (low), 38.8% (middle), 38.8% (high); n = 67 per group] and NLR cutoff of 4 [38.1% (NLR ≤ 4; n = 176), 40.0% (NLR > 4; n = 25)]. Furthermore, NLRs were not prognostic in Cox models, irrespective of subgroups used. The therapeutic effect of lanreotide autogel/depot 120 mg was independent of NLRs (P > 0.1). These exploratory post-hoc analyses in patients with advanced intestinal and pancreatic NETs contrast with previous data suggesting NLR has prognostic potential in NETs. This may reflect the inclusion of patients with lower-grade tumors or use of higher NLR cutoff values in the current analysis.

• MeSH
• dvojitá slepá metoda MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfocyty * MeSH
• nádory slinivky břišní krev   mortalita   MeSH
• neuroendokrinní nádory krev   mortalita   MeSH
• neutrofily * MeSH
• prognóza MeSH
• proporcionální rizikové modely MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

Aim: Evaluate associations between clinical outcomes and SNPs in patients with well-differentiated pancreatic neuroendocrine tumors receiving sunitinib. Patients & methods: Kaplan-Meier and Cox proportional hazards models were used to analyze the association between SNPs and survival outcomes using data from a sunitinib Phase IV (genotyped, n = 56) study. Fisher's exact test was used to analyze objective response rate and genotype associations. Results: After multiplicity adjustment, progression-free and overall survivals were not significantly correlated with SNPs; however, a higher objective response rate was significantly associated with IL1B rs16944 G/A versus G/G (46.4 vs 4.5%; p = 0.001). Conclusion:IL1B SNPs may predict treatment response in patients with pancreatic neuroendocrine tumors. VEGF pathway SNPs are potentially associated with survival outcomes.

• MeSH
• doba přežití bez progrese choroby MeSH
• farmakogenomické testování MeSH
• inhibitory proteinkinas aplikace a dávkování   škodlivé účinky   MeSH
• interleukin-1beta genetika   MeSH
• jednonukleotidový polymorfismus MeSH
• Kaplanův-Meierův odhad MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory slinivky břišní farmakoterapie   genetika   mortalita   MeSH
• neuroendokrinní nádory farmakoterapie   genetika   mortalita   MeSH
• senioři MeSH
• sunitinib aplikace a dávkování   škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze IV MeSH

BACKGROUND: In a phase III study, sunitinib led to a significant increase in progression-free survival (PFS) versus placebo in patients with pancreatic neuroendocrine tumours (panNETs). This study was a post-marketing commitment to support the phase III data. METHODS: In this ongoing, open-label, phase IV trial (NCT01525550), patients with progressive, advanced unresectable/metastatic, well-differentiated panNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to those of the phase III study. The primary endpoint was investigator-assessed PFS per Response Evaluation Criteria in Solid Tumours v1.0 (RECIST). Other endpoints included PFS per Choi criteria, overall survival (OS), objective response rate (ORR), and adverse events (AEs). RESULTS: Sixty-one treatment-naive and 45 previously treated patients received sunitinib. By March 19, 2016, 82 (77%) patients had discontinued treatment, mainly due to disease progression. Median treatment duration was 11.7 months. Investigator-assessed median PFS per RECIST (95% confidence interval [CI]) was 13.2 months (10.9-16.7): 13.2 (7.4-16.8) and 13.0 (9.2-20.4) in treatment-naive and previously treated patients, respectively. ORR (95% CI) per RECIST was 24.5% (16.7-33.8) in the total population: 21.3% (11.9-33.7) in treatment-naive and 28.9% (16.4-44.3) in previously treated patients. Median OS, although not yet mature, was 37.8 months (95% CI, 33.0-not estimable). The most common treatment-related AEs were neutropenia (53.8%), diarrhoea (46.2%), and leukopenia (43.4%). CONCLUSIONS: This phase IV trial confirms sunitinib as an efficacious and safe treatment option in patients with advanced/metastatic, well-differentiated, unresectable panNETs, and supports the phase III study outcomes. AEs were consistent with the known safety profile of sunitinib.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádory slinivky břišní farmakoterapie   mortalita   patologie   MeSH
• neuroendokrinní nádory farmakoterapie   mortalita   patologie   MeSH
• přežití bez známek nemoci MeSH
• protinádorové látky škodlivé účinky   terapeutické užití   MeSH
• senioři MeSH
• sunitinib škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: In the phase 3 RADIANT-4 trial, everolimus increased progression-free survival compared with placebo in patients with advanced, progressive, non-functional, well-differentiated gastrointestinal or lung neuroendocrine tumours (NETs). We now report the health-related quality of life (HRQOL) secondary endpoint. METHODS: RADIANT-4 is a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial done in 97 centres in 25 countries worldwide. Adults (aged ≥18 years) were eligible for the study if they had pathologically confirmed, advanced (unresectable or metastatic), non-functional, well-differentiated (grade 1 or 2) NETs of lung or gastrointestinal origin. Patients were randomly allocated (2:1) using block randomisation (block size of three) by an interactive voice response system to receive oral everolimus (10 mg per day) or placebo, both with best supportive care, with stratification by tumour origin, WHO performance status, and previous somatostatin analogue treatment. HRQOL was assessed with the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire at baseline (visit 2, day 1), every 8 weeks (± 1 week) during the study for the first 12 months after randomisation, and every 12 weeks thereafter until study drug discontinuation. The primary endpoint, reported previously, was progression-free survival assessed by central review; HRQOL was a prespecified secondary endpoint. The prespecified secondary outcome measure was time to definitive deterioration (≥7 points) in FACT-G total score. Analyses were done on the full analysis set, consisting of all randomised patients, by intention to treat. Only data obtained while receiving the randomly allocated treatment were included in this analysis. Enrolment for RADIANT-4 was completed on Aug 23, 2013, but the trial is ongoing pending final analysis of the key secondary endpoint of overall survival. This trial is registered with ClinicalTrials.gov, number NCT01524783. FINDINGS: Between April 3, 2012, and Aug 23, 2013, 302 patients were enrolled; 205 were randomly allocated everolimus and 97 were assigned placebo. At baseline, 193 (94%) of 205 patients assigned everolimus and 95 (98%) of 97 allocated placebo had completed either fully or partly the FACT-G questionnaire; at week 48, 70 (83%) of 84 patients assigned everolimus and 22 (85%) of 26 allocated placebo completed FACT-G. Median time to definitive deterioration in FACT-G total score was 11·27 months (95% CI 9·27-19·35) with everolimus and 9·23 months (5·52-not estimable) with placebo (adjusted hazard ratio 0·81, 95% CI 0·55-1·21; log-rank p=0·31). INTERPRETATION: HRQOL was maintained for patients with advanced, non-functional, gastrointestinal or lung NETs, with no relevant differences noted between the everolimus and placebo groups. In view of the previous RADIANT-4 findings of longer progression-free survival with everolimus, our findings suggest that everolimus delays disease progression while preserving overall HRQOL, even with the usual toxic effects related to active targeted drug treatment for cancer. FUNDING: Novartis Pharmaceuticals.

• MeSH
• analýza přežití MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• everolimus škodlivé účinky   terapeutické užití   MeSH
• gastrointestinální nádory farmakoterapie   mortalita   patologie   psychologie   MeSH
• hodnocení rizik MeSH
• internacionalita MeSH
• invazivní růst nádoru patologie   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic farmakoterapie   mortalita   patologie   psychologie   MeSH
• neuroendokrinní nádory farmakoterapie   mortalita   patologie   psychologie   MeSH
• placebo terapeutické užití   MeSH
• přežití bez známek nemoci MeSH
• prognóza MeSH
• proporcionální rizikové modely MeSH
• senioři MeSH
• staging nádorů MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Effective systemic therapies for patients with advanced, progressive neuroendocrine tumours of the lung or gastrointestinal tract are scarce. We aimed to assess the efficacy and safety of everolimus compared with placebo in this patient population. METHODS: In the randomised, double-blind, placebo-controlled, phase 3 RADIANT-4 trial, adult patients (aged ≥18 years) with advanced, progressive, well-differentiated, non-functional neuroendocrine tumours of lung or gastrointestinal origin were enrolled from 97 centres in 25 countries worldwide. Eligible patients were randomly assigned in a 2:1 ratio by an interactive voice response system to receive everolimus 10 mg per day orally or identical placebo, both with supportive care. Patients were stratified by tumour origin, performance status, and previous somatostatin analogue treatment. Patients, investigators, and the study sponsor were masked to treatment assignment. The primary endpoint was progression-free survival assessed by central radiology review, analysed by intention to treat. Overall survival was a key secondary endpoint. This trial is registered with ClinicalTrials.gov, number NCT01524783. FINDINGS: Between April 3, 2012, and Aug 23, 2013, a total of 302 patients were enrolled, of whom 205 were allocated to everolimus 10 mg per day and 97 to placebo. Median progression-free survival was 11·0 months (95% CI 9·2-13·3) in the everolimus group and 3·9 months (3·6-7·4) in the placebo group. Everolimus was associated with a 52% reduction in the estimated risk of progression or death (hazard ratio [HR] 0·48 [95% CI 0·35-0·67], p<0·00001). Although not statistically significant, the results of the first pre-planned interim overall survival analysis indicated that everolimus might be associated with a reduction in the risk of death (HR 0·64 [95% CI 0·40-1·05], one-sided p=0·037, whereas the boundary for statistical significance was 0·0002). Grade 3 or 4 drug-related adverse events were infrequent and included stomatitis (in 18 [9%] of 202 patients in the everolimus group vs 0 of 98 in the placebo group), diarrhoea (15 [7%] vs 2 [2%]), infections (14 [7%] vs 0), anaemia (8 [4%] vs 1 [1%]), fatigue (7 [3%] vs 1 [1%]), and hyperglycaemia (7 [3%] vs 0). INTERPRETATION: Treatment with everolimus was associated with significant improvement in progression-free survival in patients with progressive lung or gastrointestinal neuroendocrine tumours. The safety findings were consistent with the known side-effect profile of everolimus. Everolimus is the first targeted agent to show robust anti-tumour activity with acceptable tolerability across a broad range of neuroendocrine tumours, including those arising from the pancreas, lung, and gastrointestinal tract. FUNDING: Novartis Pharmaceuticals Corporation.

• MeSH
• analýza přežití MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• everolimus terapeutické užití   MeSH
• gastrointestinální nádory farmakoterapie   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nádory plic farmakoterapie   mortalita   MeSH
• neuroendokrinní nádory farmakoterapie   mortalita   MeSH
• protinádorové látky terapeutické užití   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

• MeSH
• everolimus * aplikace a dávkování   farmakokinetika   farmakologie   MeSH
• gastrointestinální nádory farmakoterapie   mortalita   MeSH
• klinické zkoušky, fáze III jako téma MeSH
• lidé MeSH
• multicentrické studie jako téma MeSH
• nádory plic farmakoterapie   mortalita   MeSH
• neuroendokrinní nádory * farmakoterapie   mortalita   MeSH
• přežití bez známek nemoci MeSH
• protinádorové látky terapeutické užití   MeSH
• randomizované kontrolované studie jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Neuroendokrinné nádory (NEN) vychádzajú z buniek difúzneho neuroendokrinného systému. Produkujú peptidy alebo amíny, ktoré účinkujú ako hormóny alebo neurotransmitery. Incidencia NEN je pomerne nízka. Diagnostika a liečba týchto tumorov je multidisciplinárna. Cieľom práce bola analýza súboru pacientov s dobre diferencovaným neuroendokrinným nádorom tráviaceho traktu. Zaradení boli pacienti sledovaní od roku 1998 do roku 2013, ktorí mali histologicky potvrdený dobre diferencovaný, nízko alebo stredne malígny neuroendokrinný nádor gastro­intestinálneho traktu. Do súboru bolo zaradených 97 pacientov. Z toho 34 (35,1 %) mužov a 63 (64,9 %) žien. Zistili sme, že v liečbe pacientov so stanovením diagnózy po roku 2005 sa signifikantne menej využíva interferón a signifikantne častejšie sa využíva endoskopická a PRRT liečba. Identifikovali sme najvhodnejší diskriminant pre rozdelenie pacientov z hľadiska výskytu metastáz v čase stanovenia diagnózy podľa hladiny 5-HIAA na 6,8 mg/24 hod, podľa hladiny CgA na 70 ng/ml. Identifikovali sme nasledovné rizikové faktory pre celkovú mortalitu: pečeňové metastázy, hnačky, flush, lokalizácia primárneho tumoru v tenkom čreve, vysoké hodnoty CgA a 5-HIAA v čase stanovenia diagnózy (5-HIAA > 520,52 mg/24 hod, CgA > 174,5 ng/ml). Ako pozitívny prognostický faktor sme identifikovali chirurgickú liečbu. Kľúčové slová: chromogranín A – kyselina 5-hydroxyindoloctová – neuroendokrinný nádor

Neuroendocrine neoplasmas are a form of cancer arising from cells of diffuse neuroendocrine system. They produce peptides or amines that act as hormones or neurotransmitters. Incidence of NENs is relatively low. Diagnostic work-up and treatment requires a multidisciplinary team approach. The aim of this study was an analysis of data from patients with well-differentiated neuroendocrine neoplasmas of gastrointestinal tract. The study included patients followed up from 1998 to 2013 with histologically confirmed well-differentiated digestive neuroendocrine neoplasm with low or intermediate malignant potential. 97 patients were included; 34 men (35.1 %) and 63 women (64.9 %). In patients being diagnosed after 2005 interferon treatment is significantly less used than endoscopic and peptide receptor radionuclide therapy. We have identified more appropriate discriminant values of 5-HIAA and chromogranin A (6.8 mg/24 hours; 70 ng/ml) for predicting the presence of metastases at the time of diagnosis. We have identified following risk factors for overall mortality: liver metastases, presence of diarrhea, flush, small bowel primary tumor, high values of CgA and 5-HIAA at the time of diagnosis (5-HIAA > 520.52 mg/24 hours, CgA > 174.5 ng/ml). Surgical treatment was found to be a positive prognostic factor. Key words: chromogranin A – 5-hydroxyindoleacetic acid – neuroendocrine neoplasm

• MeSH
• časové faktory MeSH
• chromogranin A analýza   MeSH
• dospělí MeSH
• Kaplanův-Meierův odhad MeSH
• kyselina hydroxyindoloctová analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• management nemoci * MeSH
• metastázy nádorů diagnóza   MeSH
• nádory trávicího systému * diagnóza   mortalita   terapie   MeSH
• neuroendokrinní nádory * diagnóza   mortalita   terapie   MeSH
• průjem epidemiologie   MeSH
• radionuklidy terapeutické užití   MeSH
• receptory peptidů metabolismus   MeSH
• retrospektivní studie MeSH
• rizikové faktory * MeSH
• rozložení podle pohlaví MeSH
• senioři MeSH
• somatostatin analogy a deriváty   terapeutické užití   MeSH
• statistika jako téma MeSH
• věkové faktory MeSH
• zrudnutí epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

BACKGROUND: Somatostatin analogues are commonly used to treat symptoms associated with hormone hypersecretion in neuroendocrine tumors; however, data on their antitumor effects are limited. METHODS: We conducted a randomized, double-blind, placebo-controlled, multinational study of the somatostatin analogue lanreotide in patients with advanced, well-differentiated or moderately differentiated, nonfunctioning, somatostatin receptor-positive neuroendocrine tumors of grade 1 or 2 (a tumor proliferation index [on staining for the Ki-67 antigen] of <10%) and documented disease-progression status. The tumors originated in the pancreas, midgut, or hindgut or were of unknown origin. Patients were randomly assigned to receive an extended-release aqueous-gel formulation of lanreotide (Autogel [known in the United States as Depot], Ipsen) at a dose of 120 mg (101 patients) or placebo (103 patients) once every 28 days for 96 weeks. The primary end point was progression-free survival, defined as the time to disease progression (according to the Response Evaluation Criteria in Solid Tumors, version 1.0) or death. Secondary end points included overall survival, quality of life (assessed with the European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-GI.NET21), and safety. RESULTS: Most patients (96%) had no tumor progression in the 3 to 6 months before randomization, and 33% had hepatic tumor volumes greater than 25%. Lanreotide, as compared with placebo, was associated with significantly prolonged progression-free survival (median not reached vs. median of 18.0 months, P<0.001 by the stratified log-rank test; hazard ratio for progression or death, 0.47; 95% confidence interval [CI], 0.30 to 0.73). The estimated rates of progression-free survival at 24 months were 65.1% (95% CI, 54.0 to 74.1) in the lanreotide group and 33.0% (95% CI, 23.0 to 43.3) in the placebo group. The therapeutic effect in predefined subgroups was generally consistent with that in the overall population, with the exception of small subgroups in which confidence intervals were wide. There were no significant between-group differences in quality of life or overall survival. The most common treatment-related adverse event was diarrhea (in 26% of the patients in the lanreotide group and 9% of those in the placebo group). CONCLUSIONS: Lanreotide was associated with significantly prolonged progression-free survival among patients with metastatic enteropancreatic neuroendocrine tumors of grade 1 or 2 (Ki-67 <10%). (Funded by Ipsen; CLARINET ClinicalTrials.gov number, NCT00353496; EudraCT 2005-004904-35.).

• MeSH
• cyklické peptidy škodlivé účinky   terapeutické užití   MeSH
• dvojitá slepá metoda MeSH
• gastrointestinální nádory farmakoterapie   patologie   MeSH
• léky s prodlouženým účinkem MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory slinivky břišní farmakoterapie   patologie   MeSH
• neuroendokrinní nádory farmakoterapie   mortalita   sekundární   MeSH
• přežití bez známek nemoci MeSH
• protinádorové látky škodlivé účinky   terapeutické užití   MeSH
• průjem etiologie   MeSH
• senioři MeSH
• somatostatin škodlivé účinky   analogy a deriváty   terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

Studie CLARINET dnes představuje nejsilnější randomizovanou studii zabývající se antiproliferačním efektem somatostatinových analog u pacientů s neuroendokrinními nádory. Základní studie CLARINET zahrnula 204 nemocných: pacienti měli dobře/středně diferencované nefunkční enteropankreatické neuroendokrinní tumory s proliferačním indexem Ki-67 < 10 %, v předchozích šesti měsících jim nebyla podávána žádná léková terapie, byl u nich dokumentován stav PD/SD (progressive disease/stable disease) a dostávali lanreotid nebo placebo po dobu 96 týdnů až do doby, než došlo k progresi onemocnění (dle kritérií RECIST 1.0) nebo k úmrtí. Open-label extenze (OLE) studie CLARINET zahrnula 88 nemocných: pacienti vstoupili do OLE studie, pokud měli SD na konci základní studie nebo pokud vykazovali PD při podávání placeba během základní studie; lanreotid byl podáván do doby, než došlo k další progresi onemocnění nebo k úmrtí nemocného. Medián PFS (času od randomizace k první progresi onemocnění v základní studii nebo v její OLE) při léčbě lanreotidem byl 32,8 měsíce. Medián PFS při podávání placeba v základní studii do další progrese při léčbě lanreotidem v OLE studie byl 14 měsíců. Bezpečnostní profily byly podobné ve všech podskupinách. V obou fázích studie nebyla identifikována žádná nová bezpečnostní rizika.

Today, the CLARINET study is the most powerful randomized study exploring the antiproliferative effect of somatostatin analogues in neuroendocrine tumours. The CLARINET core study (n = 204): patients had metastatic well/moderately differentiated non-functioning enteropancreatic neuroendocrine tumours with proliferative index Ki-67 < 10%, no prior medical therapy within 6 months, documented PD/SD (progressive disease/stable disease) status, and received lanreotid or placebo for 96 weeks or until PD (RECIST 1.0) or death. Open-label extension, OLE (n = 88): patients entered the OLE if they hod SD at the end of the core study or they had PD on placebo during the core study; lanreotid is administered until (further) PD or death. Median progression free survival, PES (time from randomisation to first PD in core or OLE) on lanreotid was 32.8 months. Median time from first PD on acebo (core) to further PD on lanreotid (OLE): 14.0 months (i.e., 2nd progression). Safety profiles were similar in subgroups. No new safety concerns were identified in any population.

• Klíčová slova
• lanreotid autogel,
• MeSH
• analýza přežití MeSH
• cyklické peptidy terapeutické užití   MeSH
• hodnocení léčiv * statistika a číselné údaje   MeSH
• lidé MeSH
• metastázy nádorů farmakoterapie   MeSH
• nádory trávicího systému etiologie   farmakoterapie   mortalita   MeSH
• neuroendokrinní nádory * etiologie   farmakoterapie   mortalita   MeSH
• protinádorové látky terapeutické užití   MeSH
• somatostatin * analogy a deriváty   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• neuroendokrinní nádor pankreatu,
• MeSH
• cholecystektomie MeSH
• gastrinom MeSH
• inzulinom MeSH
• karcinoid MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory jater MeSH
• nádory slinivky břišní MeSH
• neuroendokrinní nádory * chirurgie   klasifikace   mortalita   terapie   MeSH
• pooperační komplikace MeSH
• přežití MeSH
• somatostatin analogy a deriváty   MeSH
• střevní nádory MeSH
• tenké střevo MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH