Outcomes of non-metastatic poorly differentiated gastroenteropancreatic neuroendocrine neoplasms treated with surgery: a real-world population-based study.
NENs
Outcomes
Prognosis
Surgery
Journal
International journal of colorectal disease
ISSN: 1432-1262
Titre abrégé: Int J Colorectal Dis
Pays: Germany
ID NLM: 8607899
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
accepted:
29
10
2020
pubmed:
5
11
2020
medline:
24
6
2021
entrez:
4
11
2020
Statut:
ppublish
Résumé
To assess the outcomes of non-metastatic poorly differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) treated with radical surgery. Surveillance, Epidemiology, and End Results (SEER) database (1998-2015) was accessed, and patients with non-metastatic poorly differentiated/undifferentiated GEP-NENs were reviewed. Multivariable Cox regression analysis was used to evaluate factors affecting overall survival (OS) and cancer-specific survival (CSS). Patients treated with radical surgery were matched to those who did not undergo surgery through propensity score matching and Kaplan-Meier survival estimates were used to evaluate the impact of surgery in the post-propensity cohort. A total of 1517 patients were included. Within multivariable Cox regression models and compared to no surgery, radical surgery was associated with improved OS (HR: 0.41; 95% CI: 0.34-0.50) and CSS (HR: 0.37; 95% CI: 0.29-0.47). A total of 233 patients who underwent no surgery were then matched to 233 patients who underwent radical surgery. Within the post-propensity cohort, radical surgery was associated with improved OS (P < 0.001). Radical surgery is associated with improved survival outcomes in patients with non-metastatic poorly differentiated GEP-NENs. Further studies are required to better identify the best timing of radical surgery within the context of multimodal management.
Identifiants
pubmed: 33145607
doi: 10.1007/s00384-020-03793-7
pii: 10.1007/s00384-020-03793-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
941-947Références
Fazio N, Abdel-Rahman O, Spada F, Galdy S, De Dosso S, Capdevila J et al (2014) RAF signaling in neuroendocrine neoplasms: from bench to bedside. Cancer Treat Rev. 40(8):974–979
doi: 10.1016/j.ctrv.2014.06.009
Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, Kos-Kudla B, Kwekkeboom D, Rindi G, Klöppel G, Reed N, Kianmanesh R, Jensen RT, all other Vienna Consensus Conference participants (2016) ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology. 103(2):153–171
doi: 10.1159/000443171
Abdel-Rahman O, Fouad M (2015) Everolimus-based combination for the treatment of advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): biological rationale and critical review of published data. Tumour Biol. 36(2):467–478
doi: 10.1007/s13277-015-3064-4
Abdel-Rahman O, Fouad M (2015) Bevacizumab-based combination therapy for advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): a systematic review of the literature. J Cancer Res Clin Oncol. 141(2):295–305
doi: 10.1007/s00432-014-1757-5
Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, Abdalla EK, Fleming JB, Vauthey JN, Rashid A, Evans DB (2008) One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 26(18):3063–3072
doi: 10.1200/JCO.2007.15.4377
Shah MH, Goldner WS, Halfdanarson TR, Bergsland E, Berlin JD, Halperin D, Chan J, Kulke MH, Benson AB III, Blaszkowsky LS, Eads J, Engstrom PF, Fanta P, Giordano T, He J, Heslin MJ, Kalemkerian GP, Kandeel F, Khan SA, Kidwai WZ, Kunz PL, Kuvshinoff BW II, Lieu C, Pillarisetty VG, Saltz L, Sosa JA, Strosberg JR, Sussman CA, Trikalinos NA, Uboha NA, Whisenant J, Wong T, Yao JC, Burns JL, Ogba N, Zuccarino-Catania G (2018) NCCN guidelines insights: neuroendocrine and adrenal tumors, Version 2.2018. J Natl Compr Canc Netw. 16(6):693–702
doi: 10.6004/jnccn.2018.0056
Ettinger DS, Aisner DL, Wood DE, Akerley W, Bauman J, Chang JY, Chirieac LR, D'Amico TA, Dilling TJ, Dobelbower M, Govindan R, Gubens MA, Hennon M, Horn L, Lackner RP, Lanuti M, Leal TA, Lilenbaum R, Lin J, Loo BW Jr, Martins R, Otterson GA, Patel SP, Reckamp K, Riely GJ, Schild SE, Shapiro TA, Stevenson J, Swanson SJ, Tauer K, Yang SC, Gregory K, Hughes M (2018) NCCN guidelines insights: non-small cell lung cancer, Version 5.2018. J Natl Compr Canc Netw. 16(7):807–821
doi: 10.6004/jnccn.2018.0062
SEER*stat program (n.d.) Surveillance, Epidemiology, and End Results (SEER) Program ( www.seer.cancer.gov ) SEER*Stat database: incidence - SEER 18 Regs custom data (with additional treatment fields), Nov 2018 sub (1975-2016 varying) - linked to county attributes - total U.S., 1969-2017 counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2019, based on the November 2018 submission
SEER site-specific coding modules (2016). https://seer.cancer.gov/archive/manuals/2016/appendixc.html?&url=/manuals/2016/appendixc.html . Accessed 26 Sept 2020
Oberg K, Jelic S (2009) Neuroendocrine gastroenteropancreatic tumors: ESMO clinical recommendation for diagnosis, treatment and follow-up. Ann Oncol. 20(Suppl 4):150–153
doi: 10.1093/annonc/mdp158
Mosquera C, Koutlas NJ, Fitzgerald TL (2016) Localized high-grade gastroenteropancreatic neuroendocrine tumors: defining prognostic and therapeutic factors for a disease of increasing clinical significance. Eur J Surg Oncol. 42(10):1471–1477
doi: 10.1016/j.ejso.2016.07.137
Merola E, Rinke A, Partelli S, Gress TM, Andreasi V, Kollár A, Perren A, Christ E, Panzuto F, Pascher A, Jann H, Arsenic R, Cremer B, Kaemmerer D, Kump P, Lipp RW, Agaimy A, Wiedenmann B, Falconi M, Pavel ME (2020) Surgery with radical intent: is there an indication for G3 neuroendocrine neoplasms? Ann Surg Oncol. 27(5):1348–1355
doi: 10.1245/s10434-019-08049-5
Chen L, Zhou L, Zhang M, Shang L, Zhang P, Wang W, Fang C, Li J, Xu T, Tan H, Zhang P, Qiu M, Yu X, Jin K, Chen Y, Chen H, Lin R, Zhang Q, Shen L, Chen M, Li J, Li L, Chen J (2017) Clinicopathological features and prognostic validity of WHO grading classification of SI-NENs. BMC Cancer. 17(1):521
doi: 10.1186/s12885-017-3490-3
Fazio N, Milione M (2016) Heterogeneity of grade 3 gastroenteropancreatic neuroendocrine carcinomas: new insights and treatment implications. Cancer Treat Rev. 50:61–67
doi: 10.1016/j.ctrv.2016.08.006
Oronsky B, Ma PC, Morgensztern D, Carter CA (2017) Nothing but NET: a review of neuroendocrine tumors and carcinomas. Neoplasia. 19(12):991–1002
doi: 10.1016/j.neo.2017.09.002