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THE EFFECT OF PROPH...
THE EFFECT OF PROPHYLACTIC RIGHT HEMICOLECTOMY ON SURVIVAL AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH WELL-DIFFERENTIATED APPENDICEAL NEUROENDOCRINE NEOPLASMS
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- Kaltsas, G. (författare)
- Department of Propaupedic Internal Medicine, Endocrine Oncology Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
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- Alexandraki, K. I. (författare)
- Department of Propaupedic Internal Medicine, Endocrine Oncology Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
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- Poulia, K. A. (författare)
- Department of Nutrition, Laiko Hospital, Athens, Greece
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- Grozinsky-Glasberg, S. (författare)
- Neuroendocrine Tumour Unit, Endocrinology and Metabolism Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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- Pizanias, M. (författare)
- Department of Liver Transplantation, Hepatobiliary Pancreatic Surgery, King’s Healthcare Partners, King’s College Hospital, NHS FT, Institute of L, London, UK
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- Srirajaskanthan, R. (författare)
- Institute of Liver Studies, King’s College Hospital, London, UK
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- Kogut, A. (författare)
- Department of Endocrinology and Neuroendocrine Neoplasms, Depart- ment of Endocrinology and Pathophysiology, Medical University of Silesia, Katowice, Poland
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- Kos-Kudla, B. (författare)
- Department of Endocrinology and Neuroendocrine Neoplasms, Medical University of Silesia, Katowice, Poland
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- Ferreira, C. (författare)
- Department of Nuclear Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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- Weickert, M. O. (författare)
- Department of Nuclear Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK; The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Cen, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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- Daskalakis, Kosmas, 1979- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Sciences Research Laboratories, Warwick Medical School, University of Warwick, University Hospital, Coventry, UK
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(creator_code:org_t)
- John Wiley & Sons, 2020
- 2020
- Engelska.
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Ingår i: British Journal of Surgery. - : John Wiley & Sons. - 0007-1323 .- 1365-2168. ; 107:Suppl. 2, s. 14-14
- Relaterad länk:
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https://urn.kb.se/re...
Abstract
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- Background: Long-term outcomes, including health-related quality of life (HRQoL) issues are understudied in patients with well-differentiated ppendiceal neuroendocrine neoplasms (WD-ANENs). We aimed to evaluate the validity of currently applied criteria for completion prophylactic right hemicolectomy (pRHC) and determine its association with patient outcomes.Methods: This cohort study included patients with WD-ANENs from five European Centers of Excellence for neuroendocrine tumors. Eligible patients were divided between those who underwent appendectomy alone and those who underwent pRHC. HRQoL EORTCqlqc30 questionnaires and cross-sectional imaging data were prospectively collected.Results: The 166 patients included 119 women (71.2%). Mean age was 31 ± 16 years. Mean follow-up was 51 ± 54 months. Most patients (152[92%]) had tumors≤20 mm. Fifty-eight patients (34.9%) underwent pRHC that was unnecessary in 65.5%(38/58); and in 79.1%(34/43) of tumors≤20 mm. In multivariable analysis, tumor size>20 mm was the only independent predictor for lymph node (LN) positivity(p = 0.021). No disease-specific mortality was reported. Three patients developed recurrence (n = 2inthepRHC group vs. n = 1 in the appendectomy group;p = 0.263). Although global HRQol was not significantly depreciated in patients undergoing pRHC compared to appendectomy alone (median scores 0.79[0.25-1] vs. 0.83[0.08-1], respectively; p = 0.738), impaired social functioning (p = 0.016), diarrhea (p = 0.003) and financial difficulties (0.024) were more frequently reported in the pRHC group. Furthermore, physical-(p = 0.066) and role functioning (p = 0.055), as well as constipation issues(p = 0.072) emerged in the pRHC group with marginal significance.Conclusion: pRHC in WD-ANENs comes at a high rate of unnecessary procedures, functional HRQoL issues and diarrhoea. LN positivity at pRHC may lack prognostic significance, as no disease-specific mortality and scarce recurrence was evident in this series. The validity of contemporary criteria and the value per se of pRHC to patients with WD-ANEN is challenged.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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Kaltsas, G.
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Alexandraki, K. ...
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Poulia, K. A.
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Grozinsky-Glasbe ...
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Pizanias, M.
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Srirajaskanthan, ...
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Kogut, A.
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Kos-Kudla, B.
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Ferreira, C.
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Weickert, M. O.
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Daskalakis, Kosm ...
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