{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:50:00Z","timestamp":1783648200466,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001254","name":"Ipsen Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001254","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,8]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Serotonin secretion occurs in approximately 1%\u20104% of patients with a pancreatic neuroendocrine tumour (PNET<\/jats:styled-content>), but the incidence is not well defined. The aim of this study was to determine the incidence of serotonin secretion with and without carcinoid syndrome and the prognostic value for overall survival (OS<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>Data were collected from 255 patients with a PNET<\/jats:styled-content> if 24\u2010hours urinary 5\u2010hydroxyindoleacetic acid excretion (5\u2010HIAA<\/jats:styled-content>) was assessed. Patients were diagnosed with serotonin secretion if 24\u2010hours urinary 5\u2010HIAA<\/jats:styled-content> excretion was more than 3\u00d7 the upper limit of normal (ULN<\/jats:styled-content>) of 50\u00a0\u03bcmol\/24\u00a0hours during follow\u2010up. The effect of serotonin secretion on OS<\/jats:styled-content> was estimated with uni\u2010 and multivariate analyses using a Cox regression.<\/jats:p><\/jats:sec>Results<\/jats:title>Two (0.8%) patients were diagnosed with carcinoid syndrome, and another 20 (7.8%) had a serotonin\u2010secreting PNET<\/jats:styled-content> without symptoms. These patients mostly had ENETS<\/jats:styled-content> stage IV<\/jats:styled-content> disease with high chromogranin A (CgA). Serotonin secretion was a negative prognostic factor in univariate analysis (HR<\/jats:styled-content> 2.2, 95% CI<\/jats:styled-content>: 1.27\u20103.81), but in multivariate analysis, only CgA>10\u00d7 ULN<\/jats:styled-content> (HR<\/jats:styled-content>: 1.81, 95% CI<\/jats:styled-content>: 1.10\u20102.98) and neuron\u2010specific enolase (NSE<\/jats:styled-content>) >ULN<\/jats:styled-content> (HR<\/jats:styled-content>: 3.51, 95% CI<\/jats:styled-content>: 2.26\u20105.46) were predictors for OS<\/jats:styled-content>. Immunohistochemical staining for serotonin was positive in 28.6% of serotonin\u2010secreting PNET<\/jats:styled-content>s (one with carcinoid syndrome) and negative in all controls.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Carcinoid syndrome is rare in patients with a PNET<\/jats:styled-content>, but serotonin secretion occurs often. This is a negative prognostic factor for OS, but after correction for CgA and NSE<\/jats:styled-content>, it is no longer a predictor and probably only a \u201cnot\u2010so innocent bystander\u201d in patients with high tumour burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13364","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T17:32:01Z","timestamp":1493746321000},"page":"165-170","source":"Crossref","is-referenced-by-count":24,"title":["Incidence and prognostic value of serotonin secretion in pancreatic neuroendocrine tumours"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-6969","authenticated-orcid":false,"given":"Wouter T.","family":"Zandee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Sector Endocrinology ENETS Centre of Excellence Erasmus MC Cancer Institute Erasmus MC Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne 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