Long-term outcome after resection and thermal hepatic ablation of pancreatic neuroendocrine tumour liver metastases
| Autor: | Staffan Welin, Olov Norlén, Per Hellman, J. Kjaer, Anders Thornell, Peter Stålberg, Joakim Crona |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
AcademicSubjects/MED00910 Hepatic ablation Resection 03 medical and health sciences 0302 clinical medicine Overall survival Hepatectomy Humans Medicine 030212 general & internal medicine Retrospective Studies business.industry Kirurgi Liver Neoplasms Hazard ratio Retrospective cohort study General Medicine University hospital Surgery Neuroendocrine tumour Pancreatic Neoplasms 030220 oncology & carcinogenesis Original Article AcademicSubjects/MED00010 business Median survival |
| Zdroj: | BJS Open |
| Popis: | Background Pancreatic neuroendocrine tumours (Pan-NETs) are rare tumours that often present with or develop liver metastases. The aim of this retrospective study was to evaluate liver surgery and thermal hepatic ablation (THA) of Pan-NET liver metastases and to compare the outcomes with those of a control group. Method Patients with Pan-NET treated in Uppsala University Hospital and Sahlgrenska University Hospital from 1995–2018 were included. Patient records were scrutinized for baseline parameters, survival, treatment and complications. Results Some 108 patients met the criteria for inclusion; 57 patients underwent treatment with liver surgery or THA and 51 constitute the control group. Median follow-up was 3.93 years. Five-year survival in the liver surgery/THA group was 70.6 (95 per cent c.i. 0.57 to 0.84) per cent versus 42.4 (95 per cent c.i. 40.7 to 59.1) per cent in the control group (P = 0.016) and median survival was 9.1 (95 per cent c.i. 6.5 to 11.7) versus 4.3 (95 per cent c.i. 3.4–5.2) years. In a multivariable analysis, surgery or THA was associated with a decreased death-years rate (hazard ratio 0.403 (95 per cent c.i. 0.208 to 0.782, P = 0.007). Conclusion Liver surgery and/or THA was associated with longer overall survival in Pan-NET with acceptable mortality and morbidity rates. These treatments should thus be considered in Pan-NET patients with reasonable tumour burden in an intent to alleviate symptoms and to improve survival. The aim of this study was to evaluate surgery and thermal ablation of pancreatic neuroendocrine (Pan-NET) liver metastases and also to compare the outcomes with the results of a contemporary control group that included patients with Pan-NET not subjected to liver surgery or ablation and to control for any possible confounders. The present study, despite extensive control for confounders and bias evident in other studies, supports the hypothesis that liver surgery and ablative treatment of liver metastases in Pan-NETs is associated with a prolonged survival. |
| Databáze: | OpenAIRE |
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