Outcomes of Simultaneous Resection of Small Bowel Neuroendocrine Tumors with Synchronous Liver Metastases.
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Hepatectomy
/ methods
Humans
Intestinal Neoplasms
/ mortality
Intestine, Small
/ surgery
Liver Neoplasms
/ mortality
Male
Middle Aged
Neuroendocrine Tumors
/ mortality
Postoperative Complications
/ epidemiology
Retrospective Studies
Survival Analysis
Treatment Outcome
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
18
3
2020
medline:
22
1
2021
entrez:
18
3
2020
Statut:
ppublish
Résumé
This study evaluated the short- and long-term outcomes of synchronous resection of liver metastases (LM) from small bowel neuroendocrine tumors (SB-NET). A retrospective review of patients undergoing resection for LMs from SB-NETs from January 1997 and December 2018 was performed. There were 44 patients with synchronous SB-NET and LMs. Perioperative and 90-day mortality values were zero, and the morbidity rate was 27%. The median overall survival (OS) was 128.4 months (CI 95% 74.0-161.5 months) with 1-, 3-, 5-, and 10-year survival rates of 100%, 83%, 79%, and 60%, respectively. Not achieving surgical treatment for LM was the unique independent factor for survival (HR 6.50; CI 95% 1.54-27.28; p = 0.01) in patients with unresected LMs having OS and 10-year survival rates (42 months, 33%) versus patients undergoing liver resection (152 months, 66%)(p = 0.0008). The recurrence rate was 81.8% and associated with longer OS and 5-year survival rates when limited to the liver [223 months (61%) vs 94 months (87%)]. Simultaneous resection of SB-NETs with synchronous LMs was safe and associated with considerable long-term survival even in the presence of bilobar disease. However, recurrence after resection was common (81%) but associated with longer survival rates when limited to the liver.
Sections du résumé
BACKGROUND
This study evaluated the short- and long-term outcomes of synchronous resection of liver metastases (LM) from small bowel neuroendocrine tumors (SB-NET).
METHODS
A retrospective review of patients undergoing resection for LMs from SB-NETs from January 1997 and December 2018 was performed.
RESULTS
There were 44 patients with synchronous SB-NET and LMs. Perioperative and 90-day mortality values were zero, and the morbidity rate was 27%. The median overall survival (OS) was 128.4 months (CI 95% 74.0-161.5 months) with 1-, 3-, 5-, and 10-year survival rates of 100%, 83%, 79%, and 60%, respectively. Not achieving surgical treatment for LM was the unique independent factor for survival (HR 6.50; CI 95% 1.54-27.28; p = 0.01) in patients with unresected LMs having OS and 10-year survival rates (42 months, 33%) versus patients undergoing liver resection (152 months, 66%)(p = 0.0008). The recurrence rate was 81.8% and associated with longer OS and 5-year survival rates when limited to the liver [223 months (61%) vs 94 months (87%)].
CONCLUSIONS
Simultaneous resection of SB-NETs with synchronous LMs was safe and associated with considerable long-term survival even in the presence of bilobar disease. However, recurrence after resection was common (81%) but associated with longer survival rates when limited to the liver.
Identifiants
pubmed: 32179974
doi: 10.1007/s00268-020-05467-5
pii: 10.1007/s00268-020-05467-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM