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Matteo Scopel Medical Clinic III, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy

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Eugenio De Carlo Medical Clinic III, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy

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Francesca Bergamo Unit of Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

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Sabina Murgioni Unit of Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

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Riccardo Carandina Radiodiagnostic Unit, University Hospital of Padua, Padua, Italy

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Anna Rita Cervino Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy

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Marta Burei Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy

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Federica Vianello Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy

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Vittorina Zagonel Unit of Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

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Matteo Fassan Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy

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Roberto Vettor Medical Clinic III, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy

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We considered 351 patients affected by neuroendocrine tumors (NETs), followed at the University Hospital of Padua and at the Veneto Oncological Institute. Of these, 72 (20.5%) suffered from bone metastases. The sample was divided according to the timing of presentation of bone metastases into synchronous (within 6 months of diagnosis of primary tumor) and metachronous (after 6 months). We collected data on the type and grading of the primary tumor and on the features of bone metastases. Our analysis shows that the group of synchronous metastases generally presents primary tumors with a higher degree of malignancy rather than the ones of the metachronous group. This is supported by the finding of a Ki-67 level in GEP-NETs, at the diagnosis of bone metastases, significantly higher in the synchronous group. Moreover, in low-grade NETs, chromogranin A values are higher in the patients with synchronous metastases, indicating a more burden of disease. The parameters of phospho-calcium metabolism are within the normal range, and we do not find significant differences between the groups. Serious bone complications are not frequent and are not correlated with the site of origin of the primary tumor. From the analysis of the survival curves of the total sample, a cumulative survival rate of 33% at 10 years emerges. The average survival is 80 months, higher than what is reported in the literature, while the median is 84 months. In our observation period, synchronous patients tend to have a worse prognosis than metachronous ones with 52-months survival rates of 58 and 86%.

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