Serum Tumor Markers in Paraneoplastic Neurologic Syndromes: A Systematic Review of Guidelines.

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Clinical Guidelines
Authored By
Trevisiol C, Cani I, Fabricio ASC, Gion M, Giometto B, De Massis P
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Interests
Neurology
Oncology
Speciality
Neurology
Oncology
Book Detail
volume
11
ISSN
1664-2295
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ISSN
1664-2295
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true
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Additional Info
["Trevisiol C, Cani I, Fabricio ASC, Gion M, Giometto B, De Massis P","Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101546899 Publication Model: eCollection Cited Medium: Print ISSN: 1664-2295 (Print) Linking ISSN: 16642295 NLM ISO Abbreviation: Front Neurol Subsets: PubMed not MEDLINE","Systematic Review; Journal Article","2021-01-18","Frontiers in neurology [Front Neurol] 2021 Jan 18; Vol. 11, pp. 607553. Date of Electronic Publication: 2021 Jan 18 (Print Publication: 2020).","English","Frontiers in neurology","11"]
Description
Purpose: Algorithms for the detection of a malignancy in patients with unclear neurologic symptoms of suspicious paraneoplastic origins are not universally applied. Frequently, circulating tumor markers (TMs) are considered a valuable tool for cancer diagnosis in patients with paraneoplastic neurologic syndromes (PNS). Our aim was to extract the recommendations on the use of TMs and onconeural antibodies (Abs) for the diagnosis of malignancies in PNS from clinical practice guidelines and put them forward as evidence in a common framework to facilitate diffusion, dissemination, and implementation. Methods: Systematic literature searches were performed for guidelines on both oncology and PNS published since 2007. Guidelines containing information and recommendations for clinical practice pertaining to the screening and diagnosis of PNS were selected. Information on circulating TMs and onconeural Abs was extracted and synthesized in consecutive steps of increasing simplification. Results: We retrieved 799 eligible guidelines on oncology for the potential presence of information on PNS but only six covered treated diagnosis or the screening of cancer in PNS, which were then selected. Seventy-nine potentially relevant guidelines on PNS were identified as eligible and 15 were selected. Synoptic tables were prepared showing that classical TMs are not recommended for the screening or the diagnosis of a malignancy in patients with a suspected PNS. Neither should onconeural Abs be considered to screen for the presence of a malignancy, although they could be helpful to define the probability of the paraneoplastic origin of a neurologic disorder. Conclusion: The present work of synthesis may be a useful tool in the diffusion, dissemination, and implementation of guideline recommendations, potentially facilitating the decrease of the inappropriate use of circulating biomarkers for cancer screening in the presence of PNS.<br /> (Copyright © 2021 Trevisiol, Cani, Fabricio, Gion, Giometto and De Massis.)
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