Background: Cardiac metastases (CM) from neuroendocrine tumours (NET) are rare, however with the introduction of new molecular imaging modalities, such as 68Ga-DOTATATE PET-CT for NET diagnosis and re-staging, they are now identified more frequently. This study presents a single-institution experience on the NET CM characteristics, management and prognostic implications. Methods: Between January 1998 and January 2020, 25 NET patients with CM were treated in our Unit. A retrospective review of electronic records was performed. Overall survival (OS) was assessed by the Kaplan-Meier method. Cox regression models were used to evaluate the association of various clinical variables with OS. Results: The median age in the NET CM cohort was 64 years, with small intestine being the most common primary (84%). Nearly half of the patients suffered either from shortness of breath (48%) or had palpitations (12%). Peptide Receptor Radionuclide Therapy (PRRT) was applied in more than half of the patients (64%), who had an improved-trend for a longer median OS compared to those patients who did not receive PRRT (76.0 vs. 14.0 months, p = 0.196). The multivariate analysis demonstrated that concomitant skeletal or pancreatic metastases, as well as N-terminal Pro-B-type Natriuretic Peptide (NT pro-BNP) > 2 × upper limit of normal (ULN) were independent poor prognosticators. Conclusions: Clinical features of NET CM ranged from asymptomatic patients to heart failure. Concomitant bone or pancreatic metastases and NT pro-BNP levels > 2 ULN predicted shorter survival time. PRRT serves as a feasible therapy with promising survival benefits, however more data are needed.


中文翻译：

---

神经内分泌肿瘤患者的心脏转移：临床特征、治疗结果和预后意义。

背景：来自神经内分泌肿瘤 (NET) 的心脏转移 (CM) 很少见，但是随着新分子成像模式的引入，例如用于 NET 诊断和重新分期的 68Ga-DOTATATE PET-CT，它们现在被更频繁地识别。本研究介绍了有关 NET CM 特征、管理和预后影响的单一机构经验。方法：1998 年 1 月至 2020 年 1 月，25 名 NET CM 患者在我们单位接受治疗。对电子记录进行了回顾性审查。通过 Kaplan-Meier 方法评估总生存期 (OS)。Cox回归模型用于评估各种临床变量与OS的关联。结果：NET CM 队列的中位年龄为 64 岁，小肠是最常见的原发灶（84%）。近一半的患者患有气短（48%）或心悸（12%）。超过一半的患者 (64%) 接受了肽受体放射性核素治疗 (PRRT)，与未接受 PRRT 的患者相比，这些患者的中位 OS 有改善趋势（76.0 个月对 14.0 个月，p = 0.196）。多变量分析表明，伴随的骨骼或胰腺转移以及 N 端 Pro-B 型利钠肽 (NT pro-BNP) > 2 × 正常上限 (ULN) 是独立的不良预后因素。结论：NET CM 的临床特征范围从无症状患者到心力衰竭。伴随的骨或胰腺转移和 NT pro-BNP 水平 > 2 ULN 预测更短的生存时间。PRRT 作为一种可行的治疗方法，具有良好的生存益处，