Cargando…
Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection?
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 su...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778622/ https://www.ncbi.nlm.nih.gov/pubmed/35056330 http://dx.doi.org/10.3390/medicina58010022 |
_version_ | 1784637368314101760 |
---|---|
author | Kraft, Alin Croitoru, Adina Moldovan, Cosmin Lupescu, Ioana Tomescu, Dana Purnichescu-Purtan, Raluca Herlea, Vlad Popescu, Irinel Botea, Florin |
author_facet | Kraft, Alin Croitoru, Adina Moldovan, Cosmin Lupescu, Ioana Tomescu, Dana Purnichescu-Purtan, Raluca Herlea, Vlad Popescu, Irinel Botea, Florin |
author_sort | Kraft, Alin |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8778622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87786222022-01-22 Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? Kraft, Alin Croitoru, Adina Moldovan, Cosmin Lupescu, Ioana Tomescu, Dana Purnichescu-Purtan, Raluca Herlea, Vlad Popescu, Irinel Botea, Florin Medicina (Kaunas) Article 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. MDPI 2021-12-23 /pmc/articles/PMC8778622/ /pubmed/35056330 http://dx.doi.org/10.3390/medicina58010022 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kraft, Alin Croitoru, Adina Moldovan, Cosmin Lupescu, Ioana Tomescu, Dana Purnichescu-Purtan, Raluca Herlea, Vlad Popescu, Irinel Botea, Florin 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? |
title_full | Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? |
title_fullStr | Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? |
title_full_unstemmed | Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? |
title_short | Is Long-Term Survival in Metastases from Neuroendocrine Neoplasms Improved by Liver Resection? |
title_sort | is long-term survival in metastases from neuroendocrine neoplasms improved by liver resection? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778622/ https://www.ncbi.nlm.nih.gov/pubmed/35056330 http://dx.doi.org/10.3390/medicina58010022 |
work_keys_str_mv | AT kraftalin islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT croitoruadina islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT moldovancosmin islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT lupescuioana islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT tomescudana islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT purnichescupurtanraluca islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT herleavlad islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT popescuirinel islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection AT boteaflorin islongtermsurvivalinmetastasesfromneuroendocrineneoplasmsimprovedbyliverresection |