A Single Institution's Experience with Surgical Cytoreduction of Stage IV, Well-Differentiated, Small Bowel Neuroendocrine Tumors
| Autor: | Yi-Zarn Wang, Eugene A. Woltering, J. Philip Boudreaux, Lowell Anthony, Ann Porter Uhlhorn, Anne E. Diebold, D. J. Frey, Pamela Ryan |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Blood transfusion medicine.medical_treatment Kaplan-Meier Estimate Neuroendocrine tumors Single Center Postoperative Complications medicine Humans In patient Single institution Intraoperative Complications Aged Neoplasm Staging Retrospective Studies Aged 80 and over Jejunal Neoplasms business.industry Liver Neoplasms Length of Stay Middle Aged medicine.disease Well differentiated Surgery Ileal Neoplasms Survival Rate Neuroendocrine Tumors Treatment Outcome Abdominal Neoplasms Female Stage iv business Complication Follow-Up Studies |
| Zdroj: | Journal of the American College of Surgeons. 218:837-844 |
| ISSN: | 1072-7515 |
| DOI: | 10.1016/j.jamcollsurg.2013.12.035 |
| Popis: | Background Well-differentiated neuroendocrine tumors (NETs) of the gastrointestinal tract are rare, slow-growing neoplasms. Clinical outcomes in a group of stage IV, well-differentiated patients with NETs with small bowel primaries undergoing cytoreductive surgery and multidisciplinary management at a single center were evaluated. Study Design The charts of 189 consecutive patients who underwent surgical cytoreduction for their small bowel NETs were reviewed. Information on the extent of disease, complications, and Kaplan-Meier survival were collected from the patient records. Results A total of 189 patients underwent 229 cytoreductive operations. Ten percent of patients required an intraoperative blood transfusion and 3% (6 of 229) had other intraoperative complications. For all 229 procedures performed, mean (±SD) stay in the ICU was 4 ± 3 days and in the hospital was 9 ± 10 days. Before discharge, 51% of patients had no postoperative complications and 39% of patients had only minor complications. In a 30-day follow-up period from discharge, 85% of patients had no additional complications and 13% had only minor complications. The 30-day postoperative death rate was 3% (5 of 189). Mean survival from histologic diagnosis of NET was 236 months. The 5-, 10-, and 20-year Kaplan-Meier survival rates from diagnosis were 87%, 77%, and 41%, respectively. Conclusions Cytoreductive surgery in patients with well-differentiated midgut NETs has low mortality and complication rates and is associated with prolonged survival. We believe that cytoreductive surgery is a key component in the care of patients with NETs. |
| Databáze: | OpenAIRE |
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