In GI neuroendocrine neoplasms with liver metastasis, primary tumor resection linked to better survival

  • Zheng M & al.
  • Cancer Med
  • 22 Jul 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Primary tumor resection (PTR) was associated with prolonged survival among patients with gastro‐entero‐pancreatic neuroendocrine neoplasms (NEN) with liver metastases.

Why this matters

  • PTR should be considered in these patients, but age and primary tumor site, size, and differentiation should be factored into the decision.

Study design

  • Analysis of the Surveillance, Epidemiology, and End Results database (n=1547), excluding patients who had liver metastases removed.
  • Funding: National Natural Science Foundation of China.

Key results

  • 58.0% underwent PTR.
  • Median follow-up, 15 (range, 1-71) months. 42.1% of subjects died.
  • PTR was associated with better 5-year OS (57.0% vs 15.4%; P<.001 p in multivariate analysis>
  • 5-year OS, PTR vs no PTR, according to primary tumor location (P<.01 for all style="list-style-type:circle;">
  • Gastric NEN: 39.7% vs 10.5%.
  • Small intestinal NEN: 73.3% vs 29.9%.
  • Colorectal NEN: 24.6% vs 4.7%.
  • Pancreatic NEN: 59.7% vs 18.1%.
  • PTR independently predicted OS (HR, 0.48; P<.001>
  • Other factors associated with OS were:
    • Age, ≥60 years (HR, 1.58; P<.001>
    • Primary site at the small intestine (HR, 0.52; P<.001 or pancreas p=".006).</li">
    • Primary tumor size, ≥4 cm (HR, 1.58; P=.007).
    • Poor differentiation (HR, 4.48; P<.001 or undifferentiated p>
  • Limitations

    • Retrospective analysis.