DOI: 10.1007/s00259-016-3486-2Pages: 468-475

The prognostic and predictive value of sstr2-immunohistochemistry and sstr2-targeted imaging in neuroendocrine tumors

1. University Hospital Basel, Institute of Pathology

2. University Hospital Basel, Institute of Nuclear Medicine

3. University Hospital Bern, Institute of Nuclear Medicine

4. University Hospital Basel, Division of Radiological Chemistry

5. University Hospital Basel, Basel Institute for Clinical Epidemiology and Biostatistics

6. McMaster University, Department of Clinical Epidemiology and Biostatistics

7. University Bern, Institute of Pathology

Correspondence to:
Martin A. Walter
Tel: +41.31.6323542
Email: m.a.walter@gmx.net

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Abstract

Purpose

Our aim was to assess the prognostic and predictive value of somatostatin receptor 2 (sstr2) in neuroendocrine tumors (NETs).

Methods

We established a tissue microarray and imaging database from NET patients that received sstr2-targeted radiopeptide therapy with yttrium-90-DOTATOC, lutetium-177-DOTATOC or alternative treatment. We used univariate and multivariate analyses to identify prognostic and predictive markers for overall survival, including sstr2-imaging and sstr2-immunohistochemistry.

Results

We included a total of 279 patients. In these patients, sstr2-immunohistochemistry was an independent prognostic marker for overall survival (HR: 0.82, 95 % CI: 0.67 – 0.99, n = 279, p = 0.037). In DOTATOC patients, sstr2-expression on immunohistochemistry correlated with tumor uptake on sstr2-imaging (n = 170, p < 0.001); however, sstr2-imaging showed a higher prognostic accuracy (positive predictive value: +27 %, 95 % CI: 3 – 56 %, p = 0.025). Sstr2-expression did not predict a benefit of DOTATOC over alternative treatment (p = 0.93).

Conclusions

Our results suggest sstr2 as an independent prognostic marker in NETs. Sstr2-immunohistochemistry correlates with sstr2-imaging; however, sstr2-imaging is more accurate for determining the individual prognosis.

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  • Accepted: Aug 5, 2016
  • Online: Aug 18, 2016

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