Academic Journal
Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas.
| Τίτλος: | Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas. |
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| Συγγραφείς: | Galleberg RB; Department of Oncology, Haukeland University Hospital, Bergen, Norway. Electronic address: renate.berget.galleberg@helse-bergen.no., Knigge U; Departments of Surgery C and Endocrinology PE, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: rxs484@ku.dk., Tiensuu Janson E; Department of Medical Sciences, Uppsala University, Sweden. Electronic address: eva.tiensuu_janson@medsci.uu.se., Vestermark LW; Department of Oncology, Odense University Hospital, Denmark. Electronic address: lene.vestermark@syd.dk., Haugvik SP; Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Norway. Electronic address: sphaugvik@yahoo.de., Ladekarl M; Department of Oncology, Aarhus University Hospital, Denmark. Electronic address: mortlade@rm.dk., Langer SW; Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: swlanger@dadlnet.dk., Grønbæk H; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark. Electronic address: henning.gronbaek@aarhus.rm.dk., Österlund P; Department of Oncology, Helsinki University Central Hospital, Finland. Electronic address: pia.osterlund@pshp.fi., Hjortland GO; Department of Oncology, Oslo University Hospital, Norway. Electronic address: goo@ous-hf.no., Assmus J; Center for Clinical Research, Haukeland University Hospital, Bergen, Norway. Electronic address: jorg.assmus@helse-bergen.no., Tang L; Department of Pathology, MSKCC, New York, USA. Electronic address: tangl@MSKCC.ORG., Perren A; Department of Pathology, University of Bern, Switzerland. Electronic address: aurel.perren@pathology.unibe.ch., Sorbye H; Department of Oncology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway. Electronic address: Halfdan.sorbye@helse-bergen.no. |
| Πηγή: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2017 Sep; Vol. 43 (9), pp. 1682-1689. Date of Electronic Publication: 2017 May 04. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 8504356 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2157 (Electronic) Linking ISSN: 07487983 NLM ISO Abbreviation: Eur J Surg Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Original Publication: London ; New York : Academic Press, [1985- |
| Ιατρικοί όροι (MeSH): | Carcinoma, Neuroendocrine/*surgery , Intestinal Neoplasms/*pathology , Liver Neoplasms/*surgery , Pancreatic Neoplasms/*pathology , Stomach Neoplasms/*pathology, Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma, Neuroendocrine/drug therapy ; Carcinoma, Neuroendocrine/pathology ; Carcinoma, Neuroendocrine/secondary ; Catheter Ablation/adverse effects ; Hepatectomy/adverse effects ; Ki-67 Antigen/analysis ; Liver Neoplasms/drug therapy ; Liver Neoplasms/pathology ; Liver Neoplasms/secondary ; Adult ; Aged ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Recurrence ; Survival Rate |
| Περίληψη: | Background: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. Methods: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups. Results: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA. Conclusion: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population. (Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.) |
| Contributed Indexing: | Keywords: Liver; Metastases; Neuroendocrine carcinoma; Surgery; Survival |
| Substance Nomenclature: | 0 (Ki-67 Antigen) |
| Entry Date(s): | Date Created: 20170520 Date Completed: 20170912 Latest Revision: 20170912 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.ejso.2017.04.010 |
| PMID: | 28522174 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-2157 |
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| DOI: | 10.1016/j.ejso.2017.04.010 |