Surgical Management of Advanced Pancreatic Neuroendocrine Tumors: Short-Term and Long-Term Results from an International Multi-institutional Study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03

AUTHORS

David Jérémie Birnbaum, Olivier Turrini, Luca Vigano, Nadia Russolillo, Aurélie Autret, Vincent Moutardier, Lorenzo Capussotti, Yves-Patrice Le Treut, Jean-Robert Delpero, Jean Hardwigsen

ABSTRACT

BACKGROUND: The role of extended resections in the management of advanced pancreatic neuroendocrine tumors (PNETs) is not well defined. METHODS: Between 1995 and 2012, 134 patients with PNET underwent isolated (isoPNET group: 91 patients) or extended pancreatic resection (synchronous liver metastases and/or adjacent organs) (advPNET group: 43 patients). RESULTS: The associated resections included 27 hepatectomies, 9 vascular resections, 12 colectomies, 10 gastrectomies, 4 nephrectomies, 4 adrenalectomies, and 3 duodenojejunal resections. R0 was achieved in 41 patients (95%) in the advPNET. The rates of T3-T4 (73 vs 16%; p < .0001) and N+ (35 vs 13%; p = .007) were higher in the advPNET group. Mortality (5 vs 2%) and major morbidity (21 vs 19%) rates were similar between the 2 groups. The 5-year overall survival (OS) of the series was 87% in the isoPNET group and 66% in the advPNET group (p = .006). Only patients with both locally advanced disease and liver metastases showed worse survival (p = .0003). The advPNET group developed recurrence earlier [disease-free survival (DFS) at 5 years: 26 vs 81%; p < .001]. In univariate analysis, negative prognostic factors of survival were: poor degree of differentiation (p < .001), liver metastasis (p = .011), NE carcinoma (p < .001), and resection of adjacent organs (p = .013). The multivariate analysis did not highlight any factor that influenced OS. In multivariate analysis independent DFS factors were a poor degree of differentiation (p = .03) and the European Neuroendocrine Tumor Society stage (p = .01). CONCLUSIONS: An aggressive surgical approach for locally advanced or metastatic tumors is safe and offers long-term survival. More... »

PAGES

1000-1007

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-014-4016-8

DOI

http://dx.doi.org/10.1245/s10434-014-4016-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052409373

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25190116


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