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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...

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Autores principales: Kraft, Alin, Croitoru, Adina, Moldovan, Cosmin, Lupescu, Ioana, Tomescu, Dana, Purnichescu-Purtan, Raluca, Herlea, Vlad, Popescu, Irinel, Botea, Florin
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
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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.
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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
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