Current Management and Predictive Factors of Lymph Node Metastasis of Appendix Neuroendocrine Tumors : A National Study from the French Group of Endocrine Tumors (GTE)

Autor: Romain Coriat, Bernard Goichot, Rosine Guimbaud, Pierre Goudet, Christine Do Cao, Jean-Yves Scoazec, Eric Baudin, Thomas Walter, Bérénice Rault-Petit, Catherine Julié, Jeanne Ramos, Antoine Tabarin, Valérie Hervieu, Serge Guyétant, Vincent Rohmer
Přispěvatelé: Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Claude Huriez [Lille], CHU Lille, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Toulouse [Toulouse], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service de pathologie [CHU Ambroise Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Institut Gustave Roussy (IGR), Département d'imagerie médicale [Gustave Roussy], Hôpital de Hautepierre [Strasbourg], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Bordeaux [Bordeaux], Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Département de biologie et pathologie médicales [Gustave Roussy], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Annals of Surgery
Annals of Surgery, Lippincott, Williams & Wilkins, 2019, 270 (1), pp.165-171. ⟨10.1097/SLA.0000000000002736⟩
ISSN: 0003-4932
DOI: 10.1097/SLA.0000000000002736⟩
Popis: International audience; OBJECTIVE:The primary endpoint was to analyze the predictive factors of lymph node involvement (LN+).BACKGROUND:Indications for additional right hemicolectomy (RHC) with lymph node (LN) resection after appendectomy for appendix neuroendocrine tumor (A-NET) remain controversial, especially for tumors between 1 and 2 cm in size.METHODS:National study including all patients with nonmetastatic A-NET diagnosed after January, 2010 in France.RESULTS:In all, 403 patients were included. A-NETs were: within tip (67%), body (24%) or base (9%) of the appendix; tumor size was 2 cm (8%); grade 1 (91%); mesoappendix involvement 3 mm (5%); lymphovascular (15%) or perineural (24%) invasion; and positive resection margin (8%). According to the European NeuroEndocrine Tumor Society (ENETS) recommendations, 85 patients (21%) should have undergone RHC. The agreement between ENETS guidelines and the multidisciplinary tumor board for complementary RHC was 89%. In all, 100 (25%) patients underwent RHC with LN resection, 26 of whom had LN+. Tumor size (best cut-off at 1.95 cm), lymphovascular and perineural invasion, and pT classifications were associated with LN+. Among the 44 patients who underwent RHC for a tumor of 1 to 2 cm in size, 8 (18%) had LN+. No predictive factor of LN+ (base, resection margins, grade, mesoappendix, lymphovascular, perineural involvement) was found in this subgroup of patients.CONCLUSIONS:In the largest study using the latest pathological criteria for completion RHC in A-NET, a quarter of patients had residual tumor. Further studies are warranted to demonstrate the survival impact of RHC in this setting.
Databáze: OpenAIRE
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