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    Radical resection in entero-pancreatic neuroendocrine tumors: recurrence-free survival rate and definition of a risk score for recurrence

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    Authors
    Merola, E.
    Pascher, A.
    Rinke, A.
    Bartsch, D. K.
    Zerbi, A.
    Nappo, G.
    Carnaghi, C.
    Ciola, M.
    McNamara, Mairead G
    Zandee, W.
    Bertani, E.
    Marcucci, S.
    Modica, R.
    Grützmann, R.
    Fazio, N.
    de Herder, W.
    Valle, Juan W
    Gress, T. M.
    Fave, G. D.
    de Pretis, G.
    Perren, A.
    Wiedenmann, B.
    Pavel, M. E.
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    Affiliation
    Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
    Issue Date
    2022
    
    Metadata
    Show full item record
    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.
    Citation
    Merola E, Pascher A, Rinke A, Bartsch DK, Zerbi A, Nappo G, 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. Springer Science and Business Media LLC; 2022.
    Journal
    Annals of Surgical Oncology
    URI
    http://hdl.handle.net/10541/625319
    DOI
    10.1245/s10434-022-11837-1
    PubMed ID
    35583694
    Additional Links
    https://dx.doi.org/10.1245/s10434-022-11837-1
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1245/s10434-022-11837-1
    Scopus Count
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    All Christie Publications

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