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Surgery of the primary tumour in 201 patients with high-grade gastroenteropancreatic neuroendocrine and mixed neuroendocrine-non-neuroendocrine neoplasms.

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Title: Surgery of the primary tumour in 201 patients with high-grade gastroenteropancreatic neuroendocrine and mixed neuroendocrine-non-neuroendocrine neoplasms.
Authors: Pommergaard HC; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Nielsen K; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Sorbye H; Department of Oncology, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway., Federspiel B; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Tabaksblat EM; ENETS Neuroendocrine Tumor Centre of Excellence, Aarhus University Hospital, Aarhus, Denmark.; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark., Vestermark LW; Department of Oncology, Odense University Hospital, Odense, Denmark., Janson ET; ENETS Neuroendocrine Tumor Centre of Excellence, Uppsala University Hospital, Uppsala, Sweden.; Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden., Hansen CP; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Ladekarl M; ENETS Neuroendocrine Tumor Centre of Excellence, Aarhus University Hospital, Aarhus, Denmark.; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.; Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark., Garresori H; Department of Oncology, Stavanger University Hospital, Stavanger, Norway., Hjortland GO; ENETS Neuroendocrine Tumor Centre of Excellence, Oslo University Hospital, Oslo, Norway.; Department of Oncology, Oslo University Hospital, Oslo, Norway., Sundlöv A; Department of Oncology, Skåne University Hospital, Lund, Sweden., Galleberg R; Department of Oncology, Haukeland University Hospital, Bergen, Norway., Knigge P; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, University of Copenhagen and Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Kjaer A; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, University of Copenhagen and Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Langer SW; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Knigge U; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Source: Journal of neuroendocrinology [J Neuroendocrinol] 2021 May; Vol. 33 (5), pp. e12967. Date of Electronic Publication: 2021 Mar 26.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley & Sons Country of Publication: United States NLM ID: 8913461 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2826 (Electronic) Linking ISSN: 09538194 NLM ISO Abbreviation: J Neuroendocrinol Subsets: MEDLINE
Imprint Name(s): Publication: <2010->: Malden, MA : Wiley & Sons
Original Publication: Eynsham, Oxon, UK : Oxford University Press, c1989-
MeSH Terms: Intestinal Neoplasms/*surgery , Neuroendocrine Tumors/*surgery , Pancreatic Neoplasms/*surgery , Stomach Neoplasms/*surgery, Intestinal Neoplasms/mortality ; Intestinal Neoplasms/pathology ; Neuroendocrine Tumors/mortality ; Neuroendocrine Tumors/pathology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Survival Rate ; Treatment Outcome
Abstract: The benefit of surgery in high-grade gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) is uncertain. The present study aimed to investigate outcomes after tumour surgery in patients with high-grade (Ki-67 > 20%) GEP NEN or MiNEN stage I-III or stage IV. We analysed data from patients treated in the period 2007-2015 at eight Nordic university hospitals. Overall survival (OS) and progression-free survival (PFS)/disease-free survival (DFS) were analysed by Kaplan-Meier estimates. Prognostic factors were evaluated using Cox regression. We included 201 surgically resected patients, 143 stage I-III and 58 stage IV, with 68% having neuroendocrine carcinoma, 23% MiNEN, 5% neuroendocrine tumour G3 and 4% uncertain NEN G3. Primary tumours were located in colon/rectum (52%), oesophagus/cardia (19%), pancreas (10%), stomach (7%), jejunum/ileum (5%), duodenum (4%), gallbladder (2%) and anal canal (1%). For patients with stage I-III, median DFS was 12 months (95% confidence interval [CI] = 5.5-18.5) and median OS was 32 months (95% CI = 24.0-40.0). For patients with stage I-III and an R0 resection, median DFS was 21 months (95% CI = 4.9-37.1) and median OS was 39 months (95% CI = 25.0-53.0). For patients with stage IV, median PFS/DFS was 4 months (95% CI = 1.9-6.1) and median OS was 11 months (95% CI = 4.8-17.2). For patients with stage IV and an R0 resection, median DFS was 6 months (95% CI = 0-16.4) and median OS was 32 months (95% CI = 25.5-38.5). Performance status > 1 and colorectal primary were associated with poor prognosis. There was no difference in survival between patients with high-grade GEP NEN and MiNEN. Surgery of the primary tumour in patients with loco-regional high-grade GEP NEN or MiNEN led to good long-term results and should be considered if an R0 resection is considered achievable. Highly selected patients with stage IV disease may also benefit from surgery.
(© 2021 British Society for Neuroendocrinology.)
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Contributed Indexing: Keywords: gastroenteropancreatic neuroendocrine tumours; neuroendocrine carcinoma; surgery
SCR Disease Name: Gastro-enteropancreatic neuroendocrine tumor
Entry Date(s): Date Created: 20210326 Date Completed: 20220119 Latest Revision: 20220119
Update Code: 20260130
DOI: 10.1111/jne.12967
PMID: 33769624
Database: MEDLINE
Description
ISSN:1365-2826
DOI:10.1111/jne.12967