Synchronous resection of primary and liver metastases for neuroendocrine tumors Journal Article
| Authors: | Gaujoux, S.; Gonen, M.; Tang, L.; Klimstra, D.; Brennan, M. F.; D'Angelica, M.; DeMatteo, R.; Allen, P. J.; Jarnagin, W.; Fong, Y. |
| Article Title: | Synchronous resection of primary and liver metastases for neuroendocrine tumors |
| Abstract: | Background. Surgical approach is an accepted approach for metastatic neuroendocrine tumors (NET), but the safety and effectiveness of synchronous liver metastases resection with primary and/or locally recurrent NET is unclear. Methods. From 1992 to 2009, a total of 36 patients underwent synchronous resection of primary NET or local recurrence and liver metastases. Patients and tumor characteristics, surgical procedures, and postoperative and long-term outcome were reviewed. Results. Primary lesions were solitary in 28 patients (80 %), with a median size of 25 mm. Liver metastases were multiple in 32 cases (89 %), with a bilobar distribution in 29 patients (81 %) and a median size of 62 mm. Resections included gastroduodenal (n = 5), ileocolonic (n = 18), pancreatic resection (n = 13), and major hepatectomy (n = 15). Resections were R0, R1, and R2 in 13, 11, and 12 cases, respectively, and tumors were classified as G1 in 20 (56 %) andG2in15 (42 %). There was 1postoperative death after a Whipple/right trisectionectomy, and postoperative complication occurred in 16 patients (44 %). With a median follow-up of 56 months, 31 patients (89 %) experienced recurrence, which was confined to the liver in 90 %. Reduction of disease to liver only allowed subsequent liver- directed therapy, such as arterial embolization or percutaneous ablation, in 25 patients (71 %). Five-year symptom-free survival and overall survival were 60 %, and 69 %, respectively. Conclusions. In highly selected patients, an initial surgical approach combining simultaneous resection of liver metastases and primary/recurrent tumors can be performed with low mortality. Most patients develop liver-confined recurrence, which is usually amenable to ablative therapies that offer ongoing disease and symptom control. © 2012 Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 19 |
| Issue: | 13 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2012-12-01 |
| Start Page: | 4270 |
| End Page: | 4277 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 22752376 |
| DOI: | 10.1245/s10434-012-2462-8 |
| DOI/URL: | |
| Notes: | --- - Cited By (since 1996):1 - "Export Date: 1 May 2013" - "CODEN: ASONF" - ":doi 10.1245/s10434-012-2462-8" - "Source: Scopus" |
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