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The effect of proph...
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Alexandraki, Krystallenia I.Endocrine Oncology Unit, 1st Department of Propaupedic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
(författare)
The effect of prophylactic surgery in survival and HRQoL in appendiceal NEN
- Artikel/kapitelEngelska2020
Förlag, utgivningsår, omfång ...
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2020-07-24
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Springer,2020
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:oru-83196
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-83196URI
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https://doi.org/10.1007/s12020-020-02356-8DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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BACKGROUND/AIMS: Long-term outcomes are understudied in patients with well-differentiated appendiceal 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, including health-related quality of life (HRQoL).METHODS: Eligible patients from five European referral centers were divided between those who underwent appendectomy alone and those who underwent completion pRHC. HRQoL EORTC-QLC-C30 questionnaires and cross-sectional imaging data were prospectively collected. Age- and sex-matched healthy controls were recruited for HRQoL analysis' validation.RESULTS: We included 166 patients (119 women [71.2%]: mean age at baseline: 31 ± 16 years). Mean follow-up was 50.9 ± 54 months. Most patients (152 [92%]) had tumors ≤20 mm in size. Fifty-eight patients (34.9%) underwent pRHC that in final analysis was regarded as an overtreatment in 38/58 (65.5%). In multivariable analysis, tumor size >20 mm was the only independent predictor for lymph node (LN) involvement (p = 0.002). No mortality was reported, whereas 2-, 5- and 10-year recurrence-free survival in patients subjected to postoperative cross-sectional imaging (n = 136) was 98.5%, 97.8%, and 97.8%, respectively. Global HRQoL was not significantly impaired in patients with WD-ANEN compared with age- and sex-matched healthy individuals (median scores 0.83[0.08-1] vs 0.83[0.4-1], respectively; p = 0.929). Among patients with WD-ANEN impaired social functioning (p = 0.016), diarrhea (p = 0.003) and financial difficulties (0.024) were more frequently reported in the pRHC group.CONCLUSIONS: WD-ANEN is a low-malignant neoplasm with unconfirmed associated mortality, low recurrence rate, and overall preserved HRQoL. pRHC comes at a price of excessive surgery, functional HRQoL issues, and diarrhea. The value per se of a prophylactic surgical approach to patients with WD-ANENs <20 mm is challenged.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Kaltsas, GregoryEndocrine Oncology Unit, 1st Department of Propaupedic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
(författare)
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Grozinsky-Glasberg, SimonaNeuroendocrine Tumour Unit, ENETS CoE, Endocrinology and Metabolism Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
(författare)
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Oleinikov, KiraNeuroendocrine Tumour Unit, ENETS CoE, Endocrinology and Metabolism Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
(författare)
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Kos-Kudła, BeataDepartment of Endocrinology and Neuroendocrine Neoplasms, Department of Endocrinology and Pathophysiology, Medical University of Silesia, Katowice, Poland
(författare)
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Kogut, AngelikaDepartment of Endocrinology and Neuroendocrine Neoplasms, Department of Endocrinology and Pathophysiology, Medical University of Silesia, Katowice, Poland
(författare)
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Srirajaskanthan, RajaventhanENETS Centre of Excellence, Neuroendocrine Tumour Unit, King's College Hospital, London, UK; Department of Gastroenterology, King's College Hospital, London, UK
(författare)
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Pizanias, MichailDepartment of Liver Transplantation, Hepatobiliary Pancreatic Surgery, King's Healthcare Partners, King's College Hospital, NHS FT, Institute of Liver Studies, Denmark Hill, London, UK
(författare)
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Poulia, Kalliopi-AnnaDepartment of Nutrition, Laiko General Hospital, Athens, Greece
(författare)
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Ferreira, ClaraDepartment of Nuclear Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
(författare)
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Weickert, Martin O.The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK; Clinical Sciences Research Laboratories, Warwick Medical School, University of Warwick, University Hospital, Coventry, UK; Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, UK
(författare)
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Daskalakis, Kosmas,1979-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Endocrine Oncology Unit, 1st Department of Propaupedic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)kds
(författare)
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Endocrine Oncology Unit, 1st Department of Propaupedic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, GreeceNeuroendocrine Tumour Unit, ENETS CoE, Endocrinology and Metabolism Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Endocrine: Springer70:1, s. 178-1861355-008X1559-0100
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Alexandraki, Kry ...
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Kaltsas, Gregory
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Grozinsky-Glasbe ...
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Oleinikov, Kira
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Kos-Kudła, Beata
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Kogut, Angelika
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Srirajaskanthan, ...
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Pizanias, Michai ...
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Poulia, Kalliopi ...
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Ferreira, Clara
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Weickert, Martin ...
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Daskalakis, Kosm ...
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