Resection of pancreatic neuroendocrine tumors: defining patterns and time course of recurrence
| Autor: | Xu Feng Zhang, Timothy M. Pawlik, Mary Dillhoff, Alexandra G. Lopez-Aguiar, Ding Hui Dong, Sharon M. Weber, Flavio G. Rocha, Ryan C. Fields, Cliff Cho, Alexander V. Fisher, Zaheer Kanji, Eleftherios Makris, Kamran Idrees, Megan Beems, George A. Poultsides, Paula Marincola Smith, Shishir K. Maithel, Bradley A. Krasnick |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Curative resection medicine.medical_specialty Surgical margin Time Factors medicine.medical_treatment 030230 surgery Neuroendocrine tumors Article Disease-Free Survival Resection 03 medical and health sciences Pancreatectomy 0302 clinical medicine Risk Factors medicine Humans Survival rate Aged Retrospective Studies Hepatology business.industry Liver Neoplasms Gastroenterology Retrospective cohort study Middle Aged medicine.disease Surgery Pancreatic Neoplasms Survival Rate Neuroendocrine Tumors 030220 oncology & carcinogenesis Time course Female Neoplasm Recurrence Local business |
| Zdroj: | HPB (Oxford) |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2019.05.020 |
| Popis: | Background To define recurrence patterns and time course, as well as risk factors associated with recurrence following curative resection of pNETs. Method Patients who underwent curative-intent resection for pNET between 1997 and 2016 were identified from the US Neuroendocrine Tumor Study Group. Data on baseline and tumor-specific characteristics, overall survival (OS), timing and first-site of recurrence, predictors and recurrence management were analyzed. Results Among 1020 patients, 154 (15.1%) patients developed recurrence. Among patients who experienced recurrence, 76 (49.4%) had liver-only recurrence, while 35 (22.7%) had pancreas-only recurrence. The proportion of liver-only recurrence increased from 54.3% within one-year after surgery to 61.5% from four-to-six years after surgery; whereas the proportion of pancreas-only recurrence decreased from 26.1% to 7.7% over these time periods. While liver-only recurrence was associated with tumor characteristics, pancreas-only recurrence was only associated with surgical margin status. Patients undergoing curative resection of recurrence had comparable OS with patients who had no recurrence (median OS, pancreas-only recurrence, 133.9 months; liver-only recurrence, not attained; no recurrence, 143.0 months, p = 0.499) Conclusions Different recurrence patterns and timing course, as well as risk factors suggest biological heterogeneity of pNET recurrence. A personalized approach to postoperative surveillance and treatment of recurrence disease should be considered. |
| Databáze: | OpenAIRE |
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