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Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?

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Title: Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?
Authors: Selberherr, Andreas1 (AUTHOR) andreas.selberherr@meduniwien.ac.at, Freermann, Simon1 (AUTHOR), Koperek, Oskar2 (AUTHOR), Niederle, Martin B.3 (AUTHOR), Riss, Philipp1 (AUTHOR), Scheuba, Christian1 (AUTHOR), Niederle, Bruno1 (AUTHOR)
Source: Orphanet Journal of Rare Diseases. 1/14/2021, Vol. 16 Issue 1, p1-6. 6p.
Subject Terms: *LIVER metastasis, *SMALL intestine surgery, *LIVER surgery, *DIAGNOSIS, *MEDICAL records
Abstract: Background: Neuroendocrine neoplasia of the small intestine (siNEN) are frequently diagnosed with liver metastases. The impact of the presence of liver metastases on overall survival and the necessity of surgery for liver metastasis is discussed controversially. The aim of this study is to evaluate and compare the overall long-term survival of patients with siNENs with and without liver metastasis at initial diagnosis and the possible benefit of surgical treatment as compared to active surveillance of metastases. 123 consecutive patients with siNENs were treated between 1965 and 2016. All clinical and histological records were reevaluated including analysis of the proliferation rates in all specimens. The 1-, 5-, 10- and 20-year overall survival was estimated by Kaplan-Meier analysis for patients with and without liver metastasis and according to the type of treatment (surgical vs. surveillance) of liver metastases if present.Results: The 1-, 5-, 10- and 20-year overall survival rate was 89.0%, 68.4%, 52.8% and 31.0% in patients without and 89.5%, 69.5%, 33.2% and 3.6% in those with liver metastases. No statistically significant differences were observed comparing the two groups. Within the group of patients with liver metastases, the type of treatment (surgical vs. surveillance) was in favor of patients undergoing surgery. Multivariate analysis showed that the presence of liver metastases upon diagnosis was an individual risk factor associated with worse survival.Conclusion: The presence of liver metastasis at initial diagnosis does not have a statistically significant influence on survival. Surgery for hepatic metastasis seems to show a benefit for overall survival and may be indicated especially in patients symptomatic due to high tumor burden and serotonin hypersecretion to reduce hormone activity. [ABSTRACT FROM AUTHOR]
Copyright of Orphanet Journal of Rare Diseases is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
  Group: Ti
  Data: Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?
– Name: Author
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  Data: <searchLink fieldCode="AR" term="%22Selberherr%2C+Andreas%22">Selberherr, Andreas</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> andreas.selberherr@meduniwien.ac.at</i><br /><searchLink fieldCode="AR" term="%22Freermann%2C+Simon%22">Freermann, Simon</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Koperek%2C+Oskar%22">Koperek, Oskar</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Niederle%2C+Martin+B%2E%22">Niederle, Martin B.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Riss%2C+Philipp%22">Riss, Philipp</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Scheuba%2C+Christian%22">Scheuba, Christian</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Niederle%2C+Bruno%22">Niederle, Bruno</searchLink><relatesTo>1</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Orphanet+Journal+of+Rare+Diseases%22">Orphanet Journal of Rare Diseases</searchLink>. 1/14/2021, Vol. 16 Issue 1, p1-6. 6p.
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: *<searchLink fieldCode="DE" term="%22LIVER+metastasis%22">LIVER metastasis</searchLink><br />*<searchLink fieldCode="DE" term="%22SMALL+intestine+surgery%22">SMALL intestine surgery</searchLink><br />*<searchLink fieldCode="DE" term="%22LIVER+surgery%22">LIVER surgery</searchLink><br />*<searchLink fieldCode="DE" term="%22DIAGNOSIS%22">DIAGNOSIS</searchLink><br />*<searchLink fieldCode="DE" term="%22MEDICAL+records%22">MEDICAL records</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Neuroendocrine neoplasia of the small intestine (siNEN) are frequently diagnosed with liver metastases. The impact of the presence of liver metastases on overall survival and the necessity of surgery for liver metastasis is discussed controversially. The aim of this study is to evaluate and compare the overall long-term survival of patients with siNENs with and without liver metastasis at initial diagnosis and the possible benefit of surgical treatment as compared to active surveillance of metastases. 123 consecutive patients with siNENs were treated between 1965 and 2016. All clinical and histological records were reevaluated including analysis of the proliferation rates in all specimens. The 1-, 5-, 10- and 20-year overall survival was estimated by Kaplan-Meier analysis for patients with and without liver metastasis and according to the type of treatment (surgical vs. surveillance) of liver metastases if present.<bold>Results: </bold>The 1-, 5-, 10- and 20-year overall survival rate was 89.0%, 68.4%, 52.8% and 31.0% in patients without and 89.5%, 69.5%, 33.2% and 3.6% in those with liver metastases. No statistically significant differences were observed comparing the two groups. Within the group of patients with liver metastases, the type of treatment (surgical vs. surveillance) was in favor of patients undergoing surgery. Multivariate analysis showed that the presence of liver metastases upon diagnosis was an individual risk factor associated with worse survival.<bold>Conclusion: </bold>The presence of liver metastasis at initial diagnosis does not have a statistically significant influence on survival. Surgery for hepatic metastasis seems to show a benefit for overall survival and may be indicated especially in patients symptomatic due to high tumor burden and serotonin hypersecretion to reduce hormone activity. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Orphanet Journal of Rare Diseases is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1186/s13023-021-01677-9
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      – Code: eng
        Text: English
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      – SubjectFull: LIVER metastasis
        Type: general
      – SubjectFull: SMALL intestine surgery
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      – SubjectFull: LIVER surgery
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              Text: 1/14/2021
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