Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?
| Autor: | Oskar Koperek, Andreas Selberherr, Bruno Niederle, Christian Scheuba, Martin B. Niederle, Philipp Riss, Simon Freermann |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis lcsh:Medicine 030209 endocrinology & metabolism Kaplan-Meier Estimate Livermetastasis Neuroendocrine tumors Individual risk Metastasis 03 medical and health sciences 0302 clinical medicine Intestine Small medicine Humans Pharmacology (medical) In patient Genetics (clinical) Neuroendocrine neoplasia Hormone activity business.industry Research Liver Neoplasms lcsh:R General Medicine NEN Small intestine Prognosis medicine.disease Surgery Survival Rate NET medicine.anatomical_structure 030220 oncology & carcinogenesis business |
| Zdroj: | Orphanet Journal of Rare Diseases, Vol 16, Iss 1, Pp 1-6 (2021) Orphanet Journal of Rare Diseases |
| ISSN: | 1750-1172 |
| Popis: | Background Neuroendocrine neoplasia of the small intestine (siNEN) are frequently diagnosed with liver metastases. The impact of the presence of liver metastases on overall survival and the necessity of surgery for liver metastasis is discussed controversially. The aim of this study is to evaluate and compare the overall long-term survival of patients with siNENs with and without liver metastasis at initial diagnosis and the possible benefit of surgical treatment as compared to active surveillance of metastases. 123 consecutive patients with siNENs were treated between 1965 and 2016. All clinical and histological records were reevaluated including analysis of the proliferation rates in all specimens. The 1-, 5-, 10- and 20-year overall survival was estimated by Kaplan–Meier analysis for patients with and without liver metastasis and according to the type of treatment (surgical vs. surveillance) of liver metastases if present. Results The 1-, 5-, 10- and 20-year overall survival rate was 89.0%, 68.4%, 52.8% and 31.0% in patients without and 89.5%, 69.5%, 33.2% and 3.6% in those with liver metastases. No statistically significant differences were observed comparing the two groups. Within the group of patients with liver metastases, the type of treatment (surgical vs. surveillance) was in favor of patients undergoing surgery. Multivariate analysis showed that the presence of liver metastases upon diagnosis was an individual risk factor associated with worse survival. Conclusion The presence of liver metastasis at initial diagnosis does not have a statistically significant influence on survival. Surgery for hepatic metastasis seems to show a benefit for overall survival and may be indicated especially in patients symptomatic due to high tumor burden and serotonin hypersecretion to reduce hormone activity. |
| Databáze: | OpenAIRE |
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