Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
08 2020
Historique:
received: 17 12 2019
revised: 02 03 2020
accepted: 04 03 2020
pubmed: 27 3 2020
medline: 15 9 2020
entrez: 27 3 2020
Statut: ppublish

Résumé

Stage IV gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) G3 are the NENs with the worst prognosis. According to ENETS guidelines, platinum-based chemotherapy is the standard treatment for this population. Surgery is only considered in highly selected "resectable" NENs with usually lower Ki67. However, the role of surgery with curative intent has been poorly investigated. To describe, in a retrospective series of stage IV GEP-NENs G3, overall survival (OS) and recurrence-free survival (RFS) rates after curatively intended surgery. Multicenter analysis of stage IV GEP-NENs G3 receiving radical resection (R0/R1) from 2007 to 2017, with minimum post-surgical follow-up time of 3 months. Fifteen patients from 6 NEN referral centers, with median follow-up of 29 months (8-86), were included. Eight cases had a neuroendocrine carcinoma (NEC) and 7 a neuroendocrine tumor G3 (NET G3). Median OS after radical surgery was 59 months. All patients recurred, with a median RFS of 8 months. Radical surgery might be considered for highly selected stage IV GEP-NENs G3. Larger series are needed to confirm these results.

Sections du résumé

BACKGROUND
Stage IV gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) G3 are the NENs with the worst prognosis. According to ENETS guidelines, platinum-based chemotherapy is the standard treatment for this population. Surgery is only considered in highly selected "resectable" NENs with usually lower Ki67. However, the role of surgery with curative intent has been poorly investigated.
OBJECTIVE
To describe, in a retrospective series of stage IV GEP-NENs G3, overall survival (OS) and recurrence-free survival (RFS) rates after curatively intended surgery.
METHODS
Multicenter analysis of stage IV GEP-NENs G3 receiving radical resection (R0/R1) from 2007 to 2017, with minimum post-surgical follow-up time of 3 months.
RESULTS
Fifteen patients from 6 NEN referral centers, with median follow-up of 29 months (8-86), were included. Eight cases had a neuroendocrine carcinoma (NEC) and 7 a neuroendocrine tumor G3 (NET G3). Median OS after radical surgery was 59 months. All patients recurred, with a median RFS of 8 months.
CONCLUSIONS
Radical surgery might be considered for highly selected stage IV GEP-NENs G3. Larger series are needed to confirm these results.

Identifiants

pubmed: 32209239
pii: S0002-9610(20)30151-3
doi: 10.1016/j.amjsurg.2020.03.009
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

284-289

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Authors have no conflicts of interest do declare.

Auteurs

Elettra Merola (E)

Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany; Department of Gastroenterology, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy. Electronic address: elettra.merola@gmail.com.

Massimo Falconi (M)

Pancreatic Surgery Unit, Vita-Salute University, San Raffaele Hospital IRCCS, Milan, Italy.

Anja Rinke (A)

Department of Gastroenterology, Endocrinology, Metabolism and Infectiology, University Hospital Marburg and Philipps University, Marburg, Germany.

Stefan Staettner (S)

Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.

Felix Krendl (F)

Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.

Stefano Partelli (S)

Pancreatic Surgery Unit, Vita-Salute University, San Raffaele Hospital IRCCS, Milan, Italy.

Valentina Andreasi (V)

Pancreatic Surgery Unit, Vita-Salute University, San Raffaele Hospital IRCCS, Milan, Italy.

Thomas M Gress (TM)

Department of Gastroenterology, Endocrinology, Metabolism and Infectiology, University Hospital Marburg and Philipps University, Marburg, Germany.

Andreas Pascher (A)

Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Münster, Münster, Germany; Department of Surgery, Charité Universitätsmedizin, Berlin, Germany.

Ruza Arsenic (R)

Department of Pathology, Charité Mitte, Charité Universitätsmedizin, Berlin, Germany.

Claudio Doglioni (C)

Pathology Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Daniel Kaemmerer (D)

Department of General and Visceral Surgery, Zentralklinik Bad Berka, Bad Berka, Germany.

Bertram Wiedenmann (B)

Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum and Campus Mitte, Charité Universitätsmedizin, Berlin, Germany.

Marianne E Pavel (ME)

Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany; Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum and Campus Mitte, Charité Universitätsmedizin, Berlin, Germany.

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