Association between surveillance imaging and survival outcomes in small bowel neuroendocrine tumors.

Autor: Watanabe A; Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada., Mckendry G; Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada., Yip L; Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada., Loree JM; British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Stuart HC; Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2023 Mar; Vol. 127 (4), pp. 578-586. Date of Electronic Publication: 2022 Dec 19.
DOI: 10.1002/jso.27176
Abstrakt: Background: Surveillance guidelines following the resection of small bowel neuroendocrine tumors (SB-NETs) are inconsistent. We evaluated the impact of surveillance imaging on SB-NET recurrence and overall survival (OS).
Methods: Patients with completely resected SB-NETs referred to a provincial cancer center (2004-2015) were reviewed. Associations between imaging frequency, recurrence, post-recurrence treatment, and OS were determined using univariate and Cox-regression analyses.
Results: Among 195 completely resected SB-NET patients, 31% were ≥70 years, 43% were female, and 80% had grade 1 disease. Imaging frequency was predictive of recurrence (hazard ratio 2.52, 95% confidence interval 1.84-3.46, p < 0.001). 72% underwent interventions for recurrent disease. Patients who were treated for the recurrent disease had comparable OS to those who did not recur (median 152 vs. 164 months; p = 0.25). Imaging frequency was not associated with OS in those with treated recurrent disease (p = 0.65). Patients who recurred underwent more computerized tomography (CT) scans than those who did not recur (CT: 1.47 ± 0.89 vs. 1.02 ± 0.81 scans/year, p < 0.001). Detection of disease recurrence was 5%-7% per year during the first 6 years of surveillance and peaked at 17% in Year 9.
Conclusion: Less frequent imaging over a longer duration should be emphasized to capture clinically relevant recurrences that can be treated to improve OS.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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