Prognostic Factors in Curative Resected Locoregional Small Intestine Neuroendocrine Neoplasms
| Autor: | Johannes Rütz, Anja Rinke, Detlef K. Bartsch, Annette Ramaswamy, Elisabeth Maurer, Maximilian Evers |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Disease Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Intestine Small medicine Humans Prospective Studies Pathological Aged Retrospective Studies Aged 80 and over business.industry Middle Aged Vascular surgery Prognosis Small intestine Cardiac surgery medicine.anatomical_structure Cardiothoracic surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Neoplasm Recurrence Local business Abdominal surgery |
| Zdroj: | World Journal of Surgery. 45:1109-1117 |
| ISSN: | 1432-2323 0364-2313 |
| DOI: | 10.1007/s00268-020-05884-6 |
| Popis: | Small intestinal neuroendocrine neoplasms (SI-NEN) are rare, and only about 40% of patients are diagnosed without distant metastases. Aim of the study was to identify prognostic factors in patients with potentially curative resected locoregional SI-NEN.Patients with curative resected locoregional SI-NEN (ENETS stages I-III) were retrieved from a prospective data base. Demographic, surgical and pathological data of patients with and without disease recurrence were retrospectively analyzed using univariate and multivariate analysis.In a 20-year period, 65 of 203 (32%) patients with SI-NEN were operated for stages I-III disease. Thirty-eight (58.5%) patients were men, and the median age at surgery was 59 (range 37-87) years. After median follow-up of 65 months, 14 patients experienced disease relapse median 28.5 (range 6-122) months after initial surgery, of which 2 died due to their disease. Multivariate analysis revealed age ≥ 60 years (HR = 6.41, 95% CI 1.38-29.67, p = 0.017), tumor size ≥ 2 cm (HR = 26.54, 95% CI 4.46-157.62, p 0.001), lymph node ratio 0.5 (HR 7.18, 95% CI 1.74-29.74, p = 0.007) and multifocal tumor growth (HR = 6.98, 95% CI 1.66-29.39, p = 0.008) as independent negative prognostic factors and right hemicolectomy compared to segmental small bowel resection (HR = 0.04, 95% CI 0.01-0.24, p 0.001) as independent protector against recurrence.Patients with locoregional SI-NEN with an age ≥ 60 years, tumor size ≥ 2 cm, lymph node ratio 0.5 and multiple small bowel tumor foci have an increased risk for recurrence and might benefit from adjuvant treatment. In contrast, right hemicolectomy of ileal SI-NEN seems to reduce the risk of recurrence. |
| Databáze: | OpenAIRE |
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