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Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas
Haukeland Hosp, Dept Oncol, N-5021 Bergen, Norway..
Univ Copenhagen, Dept Surg C, Rigshosp, Copenhagen, Denmark.;Univ Copenhagen, Dept Endocrinol PE, Rigshosp, Copenhagen, Denmark..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrin Oncology.
Odense Univ Hosp, Dept Oncol, Odense, Denmark..
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2017 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 43, no 9, p. 1682-1689Article in journal (Refereed) Published
Abstract [en]

Background: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. Methods: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan Meier analyses for the entire cohort and for subgroups. Results: Median OS after resection/RFA of liver metastases was 35.9 months (95% -CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95% -CI: 3.9-13). Four patients (13%) were disease -free after 5 years. Two patients had well -differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 >= 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA. Conclusion: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

Place, publisher, year, edition, pages
2017. Vol. 43, no 9, p. 1682-1689
Keywords [en]
Neuroendocrine carcinoma, Metastases, Liver, Surgery, Survival
National Category
Surgery Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-335856DOI: 10.1016/j.ejso.2017.04.010ISI: 000411304100009PubMedID: 28522174OAI: oai:DiVA.org:uu-335856DiVA, id: diva2:1177694
Funder
Swedish Cancer SocietyAvailable from: 2018-01-25 Created: 2018-01-25 Last updated: 2018-01-25Bibliographically approved

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