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Benefit of Primary ...
Benefit of Primary Tumor Resection in Stage IV, Grade 1 and 2, Pancreatic Neuroendocrine Tumors : A Propensity-Score Matched Cohort Study
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- Kjaer, Josefin (author)
- Uppsala universitet,Endokrinkirurgi
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Clancy, Thomas E. (author)
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Thornell, Anders (author)
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Andersson, Niklas (author)
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- Hellman, Per (author)
- Uppsala universitet,Endokrinkirurgi
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- Crona, Joakim (author)
- Uppsala universitet,Endokrin tumörbiologi
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- Welin, Staffan (author)
- Uppsala universitet,Onkologisk endokrinologi
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Sulciner, Megan (author)
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Powell, Brittany (author)
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Brais, Lauren (author)
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Astone, Kristina (author)
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Baddoo, William (author)
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Doherty, Gerhard (author)
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Chan, Jennifer A. (author)
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- Norlén, Olov (author)
- Uppsala universitet,Endokrinkirurgi
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- Stålberg, Peter (author)
- Uppsala universitet,Endokrinkirurgi
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(creator_code:org_t)
- 2022-03
- 2022
- English.
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In: Annals of Surgery Open. - : Wolters Kluwer. - 2691-3593. ; 3:1
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
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- Objective: To determine the association of primary tumor resection in stage IV pancreatic neuroendocrine tumors (Pan-NET) and survival in a propensity-score matched study.Background: Pan-NET are often diagnosed with stage IV disease. The oncologic benefit from primary tumor resection in this scenario is debated and previous studies show contradictory results.Methods: Patients from 3 tertiary referral centers from January 1, 1985, through December 31, 2019: Uppsala University Hospital (Uppsala, Sweden), Sahlgrenska University Hospital (Gothenburg, Sweden), and Brigham and Women’s Hospital/Dana-Farber Cancer Institute (Boston, USA) were assessed for eligibility. Patients with sporadic, grade 1 and 2, stage IV pan-NET, with baseline 2000–2019 were divided between those undergoing primary tumor resection combined with oncologic treatment (surgery group [SG]), and those who received oncologic treatment without primary tumor resection (non-SG). A propensity-score matching was performed to account for the variability in the extent of metastatic disease and comorbidity. Primary outcome was overall survival.Results: Patients with stage IV Pan-NET (n = 733) were assessed for eligibility, 194 were included. Patients were divided into a SG (n = 65) and a non-SG (n = 129). Two isonumerical groups with 50 patients in each group remained after propensity-score matching. The 5-year survival was 65.4% (95% CI, 51.5-79.3) in the matched SG and 47.8% (95% CI, 30.6-65.0) in the matched non-SG (log-rank, P = 0.043).Conclusions: Resection of the primary tumor in patients with stage IV Pan-NET and G1/G2 grade was associated with prolonged overall survival compared to nonoperative management. A surgically aggressive regime should be considered where resection is not contraindicated.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Kirurgi
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Kjaer, Josefin
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Clancy, Thomas E ...
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Thornell, Anders
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Andersson, Nikla ...
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Hellman, Per
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Crona, Joakim
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show more...
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Welin, Staffan
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Sulciner, Megan
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Powell, Brittany
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Brais, Lauren
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Astone, Kristina
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Baddoo, William
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Doherty, Gerhard
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Chan, Jennifer A ...
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Norlén, Olov
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Stålberg, Peter
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Annals of Surger ...
- By the university
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Uppsala University