Abstract
Patients who suffer from gastro‐entero‐pancreatic neuroendocrine neoplasms (GEP‐NENs) often present with liver metastatic disease. The efficacy of primary tumor resection (PTR) for these patients remains controversial due to the relatively heterogeneous behavior of the primary tumor and the lack of clinical evidence. In this series, GEP‐NEN patients with liver metastases (LM) were selected from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. A logistic regression model was used to analyze variables that were associated with PTR. A Cox proportional hazards model was used to identify independent prognostic risk factors. In total, 1547 patients were enrolled in our study, including 897 patients who underwent PTR. Resection of the primary tumor was associated with prolonged survival in all patients (5‐year overall survival (OS) rates: 57.0% vs 15.4%, P < .001), and improved 5‐year OS rates were observed in patients with gastric, small intestinal, colorectal, and pancreatic subtypes (39.7%, 73.3%, 24.6%, and 59.7%, respectively). On the multivariate analysis, PTR was an independent prognostic factor of prolonged OS (HR = 0.48, 95% CI: 0.39‐0.59, P < .001). Patients with a young age (≤60 years), small intestinal or colorectal NENs, a large primary tumor, lymph node (LN) metastases, and high tumor differentiation were more likely to undergo PTR. However, patients with colorectal NENs or a large primary tumor (≥4 cm) were at an increased risk of death independently in the PTR subgroup. The risk factors for OS also included old age, gastric tumor location, and poor differentiation. In conclusion, although PTR prolonged OS in all GEP‐NEN patients presenting with LM, surgical recipients should be considered carefully. Age, primary tumor site, size, and differentiation might help surgeons identify patients who could benefit from PTR.
Highlights
Neuroendocrine neoplasms (NENs) are a relatively rare group of tumors
GEP‐NENs are slow‐growing malignancies, up to 40%‐45% of patients are initially diagnosed with distant metastases, which frequently present with liver metastases (LM).[3]
In the primary tumor resection (PTR) subgroup, we found that patients with primary tumors originating from the small intestine and pancreas had a better prognosis than those with primary tumors originating from the colorectum and stomach
Summary
Neuroendocrine neoplasms (NENs) are a relatively rare group of tumors. They used to be defined as “carcinoid” because of their heterogeneous and indolent nature. GEP‐NENs are slow‐growing malignancies, up to 40%‐45% of patients are initially diagnosed with distant metastases, which frequently present with liver metastases (LM).[3]. Since these tumors are capable of producing hormones that cause severe hormonal syndromes, patients with LM often have inferior quality of life. Patients will eventually die from tumor progression, gastrointestinal obstruction, and liver failure
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
