Publication
Hepatic Resection for Non-Functional Neuroendocrine Liver Metastasis: Does the Presence of Unresected Primary Tumor or Extrahepatic Metastatic Disease Matter?
| dc.contributor.author | Xiang, JX | |
| dc.contributor.author | Zhang, XF | |
| dc.contributor.author | Beal, EW | |
| dc.contributor.author | Weiss, M | |
| dc.contributor.author | Aldrighetti, L | |
| dc.contributor.author | Poultsides, GA | |
| dc.contributor.author | Bauer, TW | |
| dc.contributor.author | Fields, RC | |
| dc.contributor.author | Maithel, SKumar | |
| dc.contributor.author | Pinto Marques, H | |
| dc.contributor.author | Pawlik, TM | |
| dc.date.accessioned | 2019-03-12T15:58:18Z | |
| dc.date.available | 2019-03-12T15:58:18Z | |
| dc.date.issued | 2018-12 | |
| dc.description.abstract | OBJECTIVES: The objective of this study was to assess the impact of unresected primary tumor, as well as extrahepatic metastasis, on the long-term prognosis of patients undergoing hepatic resection for non-functional neuroendocrine liver metastasis (NF-NELM). METHODS: Patients who underwent hepatic resection for NF-NELM were identified from a multi-institutional database. Data on clinical and pathological details, as well as the long-term overall survival (OS) were obtained and compared. Propensity score matching was performed to generate matched pairs of patients. RESULTS: Among the 332 patients with NF-NELM, 281 (84.6%) underwent primary tumor resection, while 51 (15.4%) did not. Patients who underwent primary resection were more likely to have a pancreatic primary and metachronous NELM. The long-term OS of patients who did and did not have the primary neuroendocrine tumor (NET) resected was comparable on both unmatched (10-year survival rate 66.8% vs. 54.0%, p = 0.192) and matched (10-year survival rate 75.7% vs. 60.4%, p = 0.271) analyses. In contrast, patients with NF-NELM and extrahepatic metastasis had a worse OS following resection compared with patients who had intrahepatic-only metastasis on unmatched (10-year survival rate 37.5% vs. 69.3%, p = 0.002) and matched (10-year survival rate 37.5% vs. 86.3%, p = 0.011) analyses. On multivariable analysis, while resection of the primary NET was not associated with OS (hazard ratio [HR] 0.7, 95% confidence interval [CI] 0.4-1.2, p = 0.195), the presence of extrahepatic metastasis was independently associated with long-term risk of death (HR 3.9, 95% CI 1.7-9.2, p = 0.002). CONCLUSIONS: While surgery should be considered for patients with NF-NELM who have an unresectable primary tumor, operative resection of NF-NELM may not be as beneficial in patients with extrahepatic disease. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Ann Surg Oncol. 2018 Dec;25(13):3928-3935. | pt_PT |
| dc.identifier.doi | 10.1245/s10434-018-6751-8 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/3177 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Springer | pt_PT |
| dc.subject | HCC CIR | pt_PT |
| dc.subject | Case-Control Studies | pt_PT |
| dc.subject | Follow-Up Studies | pt_PT |
| dc.subject | Hepatectomy/mortality | |
| dc.subject | Liver Neoplasms/secondary | |
| dc.subject | Liver Neoplasms/surgery | |
| dc.subject | Lymphatic Metastasis | |
| dc.subject | Neuroendocrine Tumors/pathology | |
| dc.subject | Neuroendocrine Tumors/surgery | |
| dc.subject | Pancreatic Neoplasms/pathology | |
| dc.subject | Pancreatic Neoplasms/surgery | |
| dc.subject | Prognosis | |
| dc.subject | Survival Rate | |
| dc.title | Hepatic Resection for Non-Functional Neuroendocrine Liver Metastasis: Does the Presence of Unresected Primary Tumor or Extrahepatic Metastatic Disease Matter? | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 3935 | pt_PT |
| oaire.citation.issue | 13 | pt_PT |
| oaire.citation.startPage | 3928 | pt_PT |
| oaire.citation.title | Annals of Surgical Oncology | pt_PT |
| oaire.citation.volume | 25 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |