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Surgery of the primary tumour in 201 patients with high-grade gastroenteropancreatic neuroendocrine and mixed neuroendocrine-non-neuroendocrine neoplasms.
Pommergaard, Hans-Christian; Nielsen, Kirstine; Sorbye, Halfdan; Federspiel, Birgitte; Tabaksblat, Elizaveta M; Vestermark, Lene W; Janson, Eva T; Hansen, Carsten P; Ladekarl, Morten; Garresori, Herish; Hjortland, Geir O; Sundlöv, Anna; Galleberg, Renate; Knigge, Pauline; Kjaer, Andreas; Langer, Seppo W; Knigge, Ulrich.
Afiliación
  • Pommergaard HC; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Nielsen K; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Sorbye H; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Federspiel B; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Tabaksblat EM; Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Vestermark LW; Department of Oncology, Haukeland University Hospital, Bergen, Norway.
  • Janson ET; Department of Clinical Science, University of Bergen, Bergen, Norway.
  • Hansen CP; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Ladekarl M; Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Garresori H; ENETS Neuroendocrine Tumor Centre of Excellence, Aarhus University Hospital, Aarhus, Denmark.
  • Hjortland GO; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
  • Sundlöv A; Department of Oncology, Odense University Hospital, Odense, Denmark.
  • Galleberg R; ENETS Neuroendocrine Tumor Centre of Excellence, Uppsala University Hospital, Uppsala, Sweden.
  • Knigge P; Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden.
  • Kjaer A; ENETS Neuroendocrine Tumor Centre of Excellence, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Langer SW; Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Knigge U; ENETS Neuroendocrine Tumor Centre of Excellence, Aarhus University Hospital, Aarhus, Denmark.
J Neuroendocrinol ; 33(5): e12967, 2021 05.
Article en En | MEDLINE | ID: mdl-33769624
The benefit of surgery in high-grade gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) is uncertain. The present study aimed to investigate outcomes after tumour surgery in patients with high-grade (Ki-67 > 20%) GEP NEN or MiNEN stage I-III or stage IV. We analysed data from patients treated in the period 2007-2015 at eight Nordic university hospitals. Overall survival (OS) and progression-free survival (PFS)/disease-free survival (DFS) were analysed by Kaplan-Meier estimates. Prognostic factors were evaluated using Cox regression. We included 201 surgically resected patients, 143 stage I-III and 58 stage IV, with 68% having neuroendocrine carcinoma, 23% MiNEN, 5% neuroendocrine tumour G3 and 4% uncertain NEN G3. Primary tumours were located in colon/rectum (52%), oesophagus/cardia (19%), pancreas (10%), stomach (7%), jejunum/ileum (5%), duodenum (4%), gallbladder (2%) and anal canal (1%). For patients with stage I-III, median DFS was 12 months (95% confidence interval [CI] = 5.5-18.5) and median OS was 32 months (95% CI = 24.0-40.0). For patients with stage I-III and an R0 resection, median DFS was 21 months (95% CI = 4.9-37.1) and median OS was 39 months (95% CI = 25.0-53.0). For patients with stage IV, median PFS/DFS was 4 months (95% CI = 1.9-6.1) and median OS was 11 months (95% CI = 4.8-17.2). For patients with stage IV and an R0 resection, median DFS was 6 months (95% CI = 0-16.4) and median OS was 32 months (95% CI = 25.5-38.5). Performance status > 1 and colorectal primary were associated with poor prognosis. There was no difference in survival between patients with high-grade GEP NEN and MiNEN. Surgery of the primary tumour in patients with loco-regional high-grade GEP NEN or MiNEN led to good long-term results and should be considered if an R0 resection is considered achievable. Highly selected patients with stage IV disease may also benefit from surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendocrinos / Neoplasias Intestinales Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neuroendocrinol Asunto de la revista: ENDOCRINOLOGIA / NEUROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendocrinos / Neoplasias Intestinales Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neuroendocrinol Asunto de la revista: ENDOCRINOLOGIA / NEUROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos