{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:20:15Z","timestamp":1793035215996,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evidence is limited regarding outcome of patients with ectopic Cushing\u2019s syndrome (ECS) due to neuroendocrine tumors (NETs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We assessed the prognostic factors affecting the survival of patients with NETs and ECS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of clinicopathological features, severity of hormonal syndrome, treatments from a large cohort of patients with NETs and ECS collected from 17 Italian centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our series included 110 patients, 58.2% female, with mean (\u00b1\n                      <jats:sc>s.d.<\/jats:sc>\n                      ) age at diagnosis of 49.5\u2009\u00b1\u200915.9 years. The main sources of ectopic ACTH were bronchial carcinoids (BC) (40.9%), occult tumors (22.7%) and pancreatic (p)NETs (15.5%). Curative surgery was performed in 56.7% (70.2% of BC, 11% of pNETs). Overall survival was significantly higher in BC compared with pNETs and occult tumors (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033) and in G1-NETs compared with G2 and G3 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007). Negative predictive factors for survival were severity of hypercortisolism (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.02), hypokalemia (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), diabetes mellitus (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0146) and distant metastases (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Improved survival was observed in patients who underwent NET removal (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adrenalectomy improved short-term survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multiple factors affect prognosis of ECS patients: type of NET, grading, distant metastases, severity of hypercortisolism, hypokalemia and diabetes mellitus. BCs have the highest curative surgical rate and better survival compared with occult tumors and pNETs. Hypercortisolism plays a primary role in affecting outcome and quality of life; therefore, prompt and vigorous treatment of hormonal excess by NET surgery and medical therapy should be a key therapeutic goal. In refractory cases, adrenalectomy should be considered as it affects outcome positively at least in the first 2 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/eje-16-0809","type":"journal-article","created":{"date-parts":[[2017,2,9]],"date-time":"2017-02-09T20:40:22Z","timestamp":1486672822000},"page":"453-461","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":87,"title":["Prognostic factors in ectopic Cushing\u2019s syndrome due to neuroendocrine tumors: a multicenter study"],"prefix":"10.1093","volume":"176","author":[{"given":"Maria Vittoria","family":"Davi\u2019","sequence":"first","affiliation":[{"name":"1Section of EndocrinologyDepartment of Medicine, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Cosaro","sequence":"additional","affiliation":[{"name":"1Section of EndocrinologyDepartment of Medicine, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Piacentini","sequence":"additional","affiliation":[{"name":"2Endocrinology UnitCatholic University of Sacred Heart, Policlinico A. Gemelli, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Reimondo","sequence":"additional","affiliation":[{"name":"3Internal MedicineDepartment of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Albiger","sequence":"additional","affiliation":[{"name":"4Endocrinology UnitDepartment of Medicine DIMED, University Hospital, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Arnaldi","sequence":"additional","affiliation":[{"name":"5Clinica di Endocrinologia e Malattie del Metabolismo Ospedali Riuniti di AnconaAncona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antongiulio","family":"Faggiano","sequence":"additional","affiliation":[{"name":"6Thyroid and Parathyroid Surgery UnitIstituto Nazionale per lo Studio e la Cura dei Tumori \u2018Fondazione G. Pascale\u2019 IRCCS, Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Mantovani","sequence":"additional","affiliation":[{"name":"7Endocrinology and Diabetology UnitUniversity of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Fazio","sequence":"additional","affiliation":[{"name":"8Unit of Gastrointestinal Medical Oncology and Neuroendocrine TumorsEuropean Institute of Oncology, IEO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Piovesan","sequence":"additional","affiliation":[{"name":"9Oncological Endocrinology UnitDepartment of Medical Sciences, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Arvat","sequence":"additional","affiliation":[{"name":"9Oncological Endocrinology UnitDepartment of Medical Sciences, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"10EndocrinologyDiabetes, Metabolism and Clinical Nutrition Unit, University-Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Canu","sequence":"additional","affiliation":[{"name":"11Department of Experimental and Clinical Biomedical Sciences \u2018Mario Serio\u2019University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Mannelli","sequence":"additional","affiliation":[{"name":"11Department of Experimental and Clinical Biomedical Sciences \u2018Mario Serio\u2019University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Giacinto","family":"Ambrogio","sequence":"additional","affiliation":[{"name":"12Department of Clinical Sciences & Community HealthUniversity of Milan, Milan, Italy"},{"name":"13Neuroendocrine Research LaboratoryIstituto Auxologico Italiano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pecori Giraldi","sequence":"additional","affiliation":[{"name":"12Department of Clinical Sciences & Community HealthUniversity of Milan, Milan, Italy"},{"name":"13Neuroendocrine Research LaboratoryIstituto Auxologico Italiano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Martini","sequence":"additional","affiliation":[{"name":"14Internal MedicineDepartment of Medicine, DIMED, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lania","sequence":"additional","affiliation":[{"name":"15Department of Biomedical SciencesHumanitas University and Endocrinology Unit, Humanitas Research Hospital, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Albertelli","sequence":"additional","affiliation":[{"name":"16EndocrinologyDepartment of Internal Medicine (DiMI), University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ferone","sequence":"additional","affiliation":[{"name":"17EndocrinologyDepartment of Internal Medicine (DiMI), IRCCS, AOU San Martino IST and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Zatelli","sequence":"additional","affiliation":[{"name":"18Sezione di Endocrinologia e Medicina InternaDepartment of Medical Sciences, University of Ferrara, Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Campana","sequence":"additional","affiliation":[{"name":"19Department of Medical and Surgical SciencesUniversity of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[{"name":"20Endocrinology DivisionDepartment of Clinical Medicine and Surgery, Universit\u00e0 di Napoli Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Scaroni","sequence":"additional","affiliation":[{"name":"4Endocrinology UnitDepartment of Medicine DIMED, University Hospital, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Terzolo","sequence":"additional","affiliation":[{"name":"3Internal MedicineDepartment of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"De Marinis","sequence":"additional","affiliation":[{"name":"2Endocrinology UnitCatholic University of Sacred Heart, Policlinico A. 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