Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection?
| Title: | Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? |
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| Authors: | Alin Kraft, Adina Croitoru, Cosmin Moldovan, Ioana Lupescu, Dana Tomescu, Raluca Purnichescu-Purtan, Vlad Herlea, Irinel Popescu, Florin Botea |
| Source: | Medicina, Vol 58, Iss 1, p 22 (2021) |
| Publisher Information: | MDPI AG, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Medicine (General) |
| Subject Terms: | neuroendocrine neoplasms, liver resection, multimodal therapeutic strategy, propensity score matching, overall survival, Medicine (General), R5-920 |
| More Details: | Background and Objectives: Although many of the neuroendocrine neoplasms (NEN) have a typically prolonged natural history compared with other gastrointestinal tract cancers, at least 40% of patients develop liver metastases. This study aims to identify whether liver resection improves the overall survival of patients with liver metastases from NEN. Materials and Methods: We conducted a retrospective study at “Fundeni” Clinical Institute over a time period of 15 years; we thereby identified a series of 93 patients treated for NEN with liver metastases, which we further divided into 2 groups as follows: A (45 patients) had been subjected to liver resection complemented by systemic therapies, and B (48 patients) underwent systemic therapy alone. To reduce the patient selection bias we performed at first a propensity score matching. This was followed by a bootstrapping selection with Jackknife error correction, with the purpose of getting a statistically illustrative sample. Results: The overall survival of the matched virtual cohort under study was 41 months (95% CI 37–45). Group A virtual matched patients showed a higher survival rate (52 mo., 95% CI: 45–59) than B (31 mo., 95% CI: 27–35), (p < 0.001, Log-Rank test). Upon multivariate analysis, seven independent factors were identified to have an influence on survival: location (midgut) and primary tumor grading (G3), absence of concomitant LM, number (2–4), location (unilobar), grading (G3) of LM, and 25–50% hepatic involvement at the time of the metastatic disease diagnosis. Conclusions: Hepatic resection is nowadays the main treatment providing potential cure and prolonged survival, for patients with NEN when integrated in a multimodal strategy based on systemic therapy. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1648-9144 1010-660X |
| Relation: | https://www.mdpi.com/1648-9144/58/1/22; https://doaj.org/toc/1010-660X; https://doaj.org/toc/1648-9144 |
| DOI: | 10.3390/medicina58010022 |
| Access URL: | https://doaj.org/article/9e2e65ea3e39479eb16c9c98709bc32c |
| Accession Number: | edsdoj.9e2e65ea3e39479eb16c9c98709bc32c |
| Database: | Directory of Open Access Journals |
| ISSN: | 16489144 1010660X |
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| DOI: | 10.3390/medicina58010022 |
| Published in: | Medicina |
| Language: | English |