Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

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Galleberg , R B , Knigge , U , Janson , E T , Vestermark , L W , Haugvik , S -P , Ladekarl , M , Langer , S W , Gronbaek , H , Osterlund , P , Hjortland , G O , Assmus , J , Tang , L , Perren , A & Sorbye , H 2017 , ' Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas ' , European Journal of Surgical Oncology , vol. 43 , no. 9 , pp. 1682-1689 . https://doi.org/10.1016/j.ejso.2017.04.010

Title: Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas
Author: Galleberg, R. B.; Knigge, U.; Janson, E. Tiensuu; Vestermark, L. W.; Haugvik, S. -P.; Ladekarl, M.; Langer, S. W.; Gronbaek, H.; Osterlund, P.; Hjortland, G. O.; Assmus, J.; Tang, L.; Perren, A.; Sorbye, H.
Contributor: University of Helsinki, Clinicum
Date: 2017-09
Language: eng
Number of pages: 8
Belongs to series: European Journal of Surgical Oncology
ISSN: 0748-7983
URI: http://hdl.handle.net/10138/297993
Abstract: 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. (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Subject: Neuroendocrine carcinoma
Metastases
Liver
Surgery
Survival
ENETS CONSENSUS GUIDELINES
LONG-TERM SURVIVAL
HEPATIC RESECTION
NEOPLASMS
TUMORS
G3
CHEMOTHERAPY
MANAGEMENT
DIAGNOSIS
EXPERIENCE
3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
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