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Management and Outcomes of Patients With Recurrent Neuroendocrine Liver Metastasis After Curative Surgery: An International Multi-Institutional Analysis

2017-09Journal article Open access
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dc.contributor.authorSpolverato, G
dc.contributor.authorBagante, F
dc.contributor.authorAldrighetti, L
dc.contributor.authorPoultsides, GA
dc.contributor.authorBauer, TW
dc.contributor.authorFields, RC
dc.contributor.authorMaithel, SK
dc.contributor.authorPinto Marques, H
dc.contributor.authorWeiss, M
dc.contributor.authorPawlik, TM
dc.date.accessioned2019-03-14T15:22:25Z
dc.date.available2019-03-14T15:22:25Z
dc.date.issued2017-09
dc.description.abstractOBJECTIVE: We sought to characterize the treatment, as well as define the long-term outcomes, of patients with recurrent neuroendocrine liver metastasis (NELM). METHODS: Between 1990 and 2014, 322 patients undergoing curative intent liver surgery for NELM were identified from a multi-institutional database. Recurrences were classified as intrahepatic, extrahepatic, and both intra- and extra-hepatic. RESULTS: Overall, median, 1-, 5-, 10-year DFS were 3.1 years, 75.5%, 40.4%, and 32.1%, respectively. After curative intent liver surgery, 209 patients (64.9%) recurred within a median follow-up of 4.5 years, while 113 (35.1%) patients were alive without disease with a follow-up time ≥3 years. The site of recurrence was intrahepatic only (n = 111, 65.7%), extrahepatic only (n = 19, 11.2%), or intra- and extra-hepatic (n = 39, 23.1%). Compared with intrahepatic only recurrence, extrahepatic only, and combined intra- and extra-hepatic recurrence were associated with a worse long-term outcome (10-year OS: intrahepatic only, 42.5%, 95%CI, 24.9-59.0 vs extrahepatic only, 0% and combined intra- and extra-hepatic, 21.5%, 95%CI, 5.3-44.0) (P < 0.001). Most patients were treated with repeat surgery (n = 49, 36.6%), while 34 (23.5%) patients received a somatostatin analogue, 27 (18.6%) systemic cytotoxic chemotherapy, and 27 (21.4%) patients had intra-arterial therapy. Ten-year OS among patients who underwent repeat surgery or intra-arterial treatments was 60.3% (95%CI, 34.1-78.8) and 52.0% (95%CI, 30.6-69.9), respectively. Patients who received somatostatin analogues (45.9% 95%CI, 22.3-66.9) or systemic chemotherapy (0%) had a shorter long-term survival (P = 0.001). CONCLUSION: Recurrence after surgery for NELM occurred among half of patients. Repeat liver resection for recurrence may offer a reasonable 5-year survival benefit.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Surg Oncol. 2017 Sep;116(3):298-306.pt_PT
dc.identifier.doi10.1002/jso.24670pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3200
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAgedpt_PT
dc.subjectColorectal Neoplasmspt_PT
dc.subjectCombined Modality Therapypt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectLiver Neoplasmspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectNeoplasm Recurrence, Localpt_PT
dc.subjectReoperationpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectSurvival Ratept_PT
dc.subjectTreatment Outcomept_PT
dc.subjectHepatectomypt_PT
dc.subjectHCC CIRpt_PT
dc.titleManagement and Outcomes of Patients With Recurrent Neuroendocrine Liver Metastasis After Curative Surgery: An International Multi-Institutional Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage306pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage298pt_PT
oaire.citation.titleJournal of Surgical Oncologypt_PT
oaire.citation.volume116pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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