Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence

Merola E, Pascher A, Rinke A, Bartsch DK, Zerbi A, Nappo G, Carnaghi C, Ciola M, Mcnamara MG, Zandee W, Bertani E, Marcucci S, Modica R, Grützmann R, Fazio N, De Herder W, Valle JW, Gress TM, Fave GD, De Pretis G, Perren A, Wiedenmann B, Pavel ME (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Annals of Surgical Oncology Springer Verlag (Germany)

DOI: 10.1245/s10434-022-11837-1

Abstract

Background Surgery with radical intent is the only potentially curative option for entero-pancreatic neuroendocrine tumors (EP-NETs) but many patients develop recurrence even after many years. The subset of patients at high risk of disease recurrence has not been clearly defined to date. Objective The aim of this retrospective study was to define, in a series of completely resected EP-NETs, the recurrence-free survival (RFS) rate and a risk score for disease recurrence. Patients and Methods This was a multicenter retrospective analysis of sporadic pancreatic NETs (PanNETs) or small intestine NETs (SiNETs) [G1/G2] that underwent R0/R1 surgery (years 2000-2016) with at least a 24-month follow-up. Survival analysis was performed using the Kaplan-Meier method and risk factor analysis was performed using the Cox regression model. Results Overall, 441 patients (224 PanNETs and 217 SiNETs) were included, with a median Ki67 of 2% in tumor tissue and 8.2% stage IV disease. Median RFS was 101 months (5-year rate 67.9%). The derived prognostic score defined by multivariable analysis included prognostic parameters, such as TNM stage, lymph node ratio, margin status, and grading. The score distinguished three risk categories with a significantly different RFS (p < 0.01). Conclusions Approximately 30% of patients with EP-NETs recurred within 5 years after radical surgery. Risk factors for recurrence were disease stage, lymph node ratio, margin status, and grading. The definition of risk categories may help in selecting patients who might benefit from adjuvant treatments and more intensive follow-up programs.

Authors with CRIS profile

Robert Grützmann Lehrstuhl für Allgemein- und Viszeralchirurgie Marianne Ellen Pavel Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Istituto Clinico Humanitas IT Italy (IT) University of Manchester GB United Kingdom (GB) Istituto di ricovero e cura a carattere scientifico (IRCCS) IT Italy (IT) Erasmus University Medical Center (MC) NL Netherlands (NL) Zentralkrankenhaus Bozen IT Italy (IT) Christie NHS Foundation Trust GB United Kingdom (GB) Università degli Studi di Napoli Federico II IT Italy (IT) Ospedale Santa Chiara IT Italy (IT) Università degli studi "La Sapienza" IT Italy (IT) Universität Bern CH Switzerland (CH) Philipps-Universität Marburg DE Germany (DE)

How to cite

APA:

Merola, E., Pascher, A., Rinke, A., Bartsch, D.K., Zerbi, A., Nappo, G.,... Pavel, M.E. (2022). Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence. Annals of Surgical Oncology. https://doi.org/10.1245/s10434-022-11837-1

MLA:

Merola, Elettra, et al. "Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence." Annals of Surgical Oncology (2022).

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