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Cytoreductive Debulking Surgery Among Patients with Neuroendocrine Liver Metastasis: a Multi-Institutional Analysis

2018Journal article Open access
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dc.contributor.authorEjaz, A
dc.contributor.authorReames, BN
dc.contributor.authorMaithel, S
dc.contributor.authorPoultsides, GA
dc.contributor.authorBauer, TW
dc.contributor.authorFields, RC
dc.contributor.authorWeiss, MJ
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorPawlik, TM
dc.date.accessioned2019-03-14T15:14:25Z
dc.date.available2019-03-14T15:14:25Z
dc.date.issued2018
dc.description.abstractBACKGROUND: Management of neuroendocrine liver metastasis (NELM) in the setting of unresectable disease is poorly defined and the role of debulking remains controversial. The objective of the current study was to define outcomes following non-curative intent liver-directed therapy (debulking) among patients with NELM. METHODS: 612 patients were identified who underwent liver-directed therapy of NELM from a multi-institutional database. Outcomes were stratified according to curative (R0/R1) versus non-curative ≥ 80% debulking (R2). RESULTS: 179 (29.2%) patients had an R2/debulking procedure. Patients undergoing debulking more commonly had more aggressive high-grade tumors (R0/R1: 12.8% vs. R2: 35.0%; P < 0.001) or liver disease burden that was bilateral (R0/R1: 52.8% vs. R2: 75.6%; P < 0.001). After a median follow-up of 51 months, median (R0/R1: not reached vs. R2: 87 months; P < 0.001) and 5-year survival (R0/R1: 85.2% vs. R2: 60.7%; P < 0.001) was higher among patients who underwent an R0/R1 resection compared with patients who underwent a debulking operation. Among patients with ≥50% NELM liver involvement, median and 5-year survival following debulking was 55.4 months and 40.6%, respectively. CONCLUSION: Debulking operations for NELM provided reasonable long-term survival. Hepatic debulking for patients with NELM is a reasonable therapeutic option for patients with grossly unresectable disease that may provide a survival benefit.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHPB (Oxford). 2018 Mar;20(3):277-284.pt_PT
dc.identifier.doi10.1016/j.hpb.2017.08.039pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3199
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectCarcinoma, Neuroendocrine/mortalitypt_PT
dc.subjectCarcinoma, Neuroendocrine/secondarypt_PT
dc.subjectCarcinoma, Neuroendocrine/surgery
dc.subjectCytoreduction Surgical Procedures/adverse effects
dc.subjectCytoreduction Surgical Procedures/mortality
dc.subjectDatabases, Factual
dc.subjectEurope
dc.subjectLiver Neoplasms/mortality
dc.subjectLiver Neoplasms/secondary
dc.subjectLiver Neoplasms/surgery
dc.subjectNeoplasm Grading
dc.subjectRetrospective Studies
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectUnited States
dc.titleCytoreductive Debulking Surgery Among Patients with Neuroendocrine Liver Metastasis: a Multi-Institutional Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage284pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage277pt_PT
oaire.citation.titleHPBpt_PT
oaire.citation.volume20pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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