Serotonin levels and 1-year mortality in patients with neuroendocrine tumors: a systematic review and meta-analysis

• Published in: Future oncology (London, England) Vol. 15; no. 12; pp. 1397 - 1406
• Main Authors: Joish, Vijay N, Shah, Sandip, Tierce, Jonothan C, Patel, Deep, McKee, Chad, Lapuerta, Pablo, Zacks, Jerome
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.04.2019
• Subjects: carcinoid syndrome; Cardiovascular disease; Fibroblasts; Growth factors; Heart; Literature reviews; Maximum likelihood method; Meta-analysis; Mortality; Neuroendocrine tumors; Patients; Serotonin; Studies; Surgery; Systematic review; mortality; serotonin; carcinoid syndrome; neuroendocrine tumors
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2018-0960

Elevated serotonin in patients with neuroendocrine tumors (NETs) may impact heart failure incidence but a quantitative relationship has not been established. Systematic review and meta-analysis of studies assessing 24-h urinary 5-hydroxyindoleacetic acid (u5-HIAA) and mortality in patients with NETs (2007-2017) with a primary outcome of 1-year mortality risk and 24-h u5-HIAA. We identified 1715 records of which 12 studies including 755 patients (3442 person-years with 376 deaths) were eligible for meta-analysis. Mean u5-HIAA was 149.2 mg/24 h (standard deviation: 96.6) and mortality was 13.0%. The meta-regression equation showed an 11.8% (95% CI: 8.9-17.0%; = 93.0%) increase in 1-year mortality for every ten-unit increase in u5-HIAA. Serotonin measured by its metabolite u5-HIAA is predictive of 1-year all-cause mortality in patients with NETs.