Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas.

Galleberg, R B; Knigge, U; Tiensuu Janson, E; Vestermark, L W; Haugvik, S-P; Ladekarl, M; Langer, S W; Grønbæk, H; Österlund, P; Hjortland, G O; Assmus, J; Tang, L; Perren, Aurel; Sorbye, H (2017). Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas. European journal of surgical oncology EJSO, 43(9), pp. 1682-1689. Elsevier 10.1016/j.ejso.2017.04.010

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BACKGROUND Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. METHODS 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups. RESULTS Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA. CONCLUSION This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Perren, Aurel

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0748-7983

Publisher:

Elsevier

Language:

English

Submitter:

Aurel Perren

Date Deposited:

16 Oct 2017 15:58

Last Modified:

16 Oct 2017 16:06

Publisher DOI:

10.1016/j.ejso.2017.04.010

PubMed ID:

28522174

Uncontrolled Keywords:

Liver Metastases Neuroendocrine carcinoma Surgery Survival

BORIS DOI:

10.7892/boris.106014

URI:

https://boris.unibe.ch/id/eprint/106014

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