Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1-2 cm in size: a retrospective, Europe-wide, pooled cohort study

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Nesti, CedricUniv Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, Switzerland (författare)

Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1-2 cm in size : a retrospective, Europe-wide, pooled cohort study

Artikel/kapitelEngelska2023

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Elsevier,2023
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LIBRIS-ID:oai:DiVA.org:uu-512812
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512812URI
https://doi.org/10.1016/S1470-2045(22)00750-1DOI

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Språk:engelska
Sammanfattning på:engelska

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BackgroundAwareness of the potential global overtreatment of patients with appendiceal neuroendocrine tumours (NETs) of 1–2 cm in size by performing oncological resections is increasing, but the rarity of this tumour has impeded clear recommendations to date. We aimed to assess the malignant potential of appendiceal NETs of 1–2 cm in size in patients with or without right-sided hemicolectomy.MethodsIn this retrospective cohort study, we pooled data from 40 hospitals in 15 European countries for patients of any age and Eastern Cooperative Oncology Group performance status with a histopathologically confirmed appendiceal NET of 1–2 cm in size who had a complete resection of the primary tumour between Jan 1, 2000, and Dec 31, 2010. Patients either had an appendectomy only or an appendectomy with oncological right-sided hemicolectomy or ileocecal resection. Predefined primary outcomes were the frequency of distant metastases and tumour-related mortality. Secondary outcomes included the frequency of regional lymph node metastases, the association between regional lymph node metastases and histopathological risk factors, and overall survival with or without right-sided hemicolectomy. Cox proportional hazards regression was used to estimate the relative all-cause mortality hazard associated with right-sided hemicolectomy compared with appendectomy alone. This study is registered with ClinicalTrials.gov, NCT03852693.Findings282 patients with suspected appendiceal tumours were identified, of whom 278 with an appendiceal NET of 1–2 cm in size were included. 163 (59%) had an appendectomy and 115 (41%) had a right-sided hemicolectomy, 110 (40%) were men, 168 (60%) were women, and mean age at initial surgery was 36·0 years (SD 18·2). Median follow-up was 13·0 years (IQR 11·0–15·6). After centralised histopathological review, appendiceal NETs were classified as a possible or probable primary tumour in two (1%) of 278 patients with distant peritoneal metastases and in two (1%) 278 patients with distant metastases in the liver. All metastases were diagnosed synchronously with no tumour-related deaths during follow-up. Regional lymph node metastases were found in 22 (20%) of 112 patients with right-sided hemicolectomy with available data. On the basis of histopathological risk factors, we estimated that 12·8% (95% CI 6·5 –21·1) of patients undergoing appendectomy probably had residual regional lymph node metastases. Overall survival was similar between patients with appendectomy and right-sided hemicolectomy (adjusted hazard ratio 0·88 [95% CI 0·36–2·17]; p=0·71).InterpretationThis study provides evidence that right-sided hemicolectomy is not indicated after complete resection of an appendiceal NET of 1–2 cm in size by appendectomy, that regional lymph node metastases of appendiceal NETs are clinically irrelevant, and that an additional postoperative exclusion of metastases and histopathological evaluation of risk factors is not supported by the presented results. These findings should inform consensus best practice guidelines for this patient cohort.

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Biuppslag (personer, institutioner, konferenser, titlar ...)

Bräutigam, KonstantinUniv Bern, Inst Pathol, Bern, Switzerland (författare)
Benavent, MartaUniv Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain (författare)
Bernal, LauraUniv Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain (författare)
Boharoon, HessaRoyal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England (författare)
Botling, JohanUppsala universitet,Cancerprecisionsmedicin(Swepub:uu)johanbot (författare)
Bouroumeau, AntoninUniv Hosp Geneva, Div Clin Pathol, Diagnost Dept, Geneva, Switzerland (författare)
Brcic, IvaMed Univ Graz, Diagnost & Res Inst Pathol, Graz, Austria (författare)
Brunner, MaximilianFriedrich Alexander Univ Erlangen Nurnberg, Dept Surg, Univ Hosp, Erlangen, Germany (författare)
Cadiot, GuillaumeUniv Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France (författare)
Camara, MariaUCM, Imas12, Hosp Univ 12 Octubre, Dept Pathol, Madrid, Spain (författare)
Christ, EmanuelUniv Hosp Basel, ENETS Ctr Excellence, Dept Endocrinol Diabetol & Metab, Basel, Switzerland (författare)
Clerici, ThomasKantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland (författare)
Clift, Ashley K.Imperial Coll London, Dept Surg & Canc, London, England (författare)
Clouston, HamishChristie NHS Fdn Trust, Colorectal & Peritoneal Oncol Ctr, Manchester, Lancs, England (författare)
Cobianchi, LorenzoUniv Pavia, Dept Clin Diagnost & Pediat Sci, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Dept Gen Surg, Pavia, Italy (författare)
Cwikla, Jaroslaw B.Indywidualna Specjalistyczna Praktyka Lekarska, Warsaw, Poland (författare)
Daskalakis, KosmasNatl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece (författare)
Frilling, AndreaImperial Coll London, Dept Surg & Canc, London, England (författare)
Garcia-Carbonero, RocioUCM, Imas12, Hosp Univ 12 Octubre, Dept Oncol, Madrid, Spain (författare)
Grozinsky-Glasberg, SimonaHebrew Univ Jerusalem, Hadassah Med Org, Neuroendocrine Tumor Unit, ENETS Ctr Excellence,Dept Endocrinol & Metab, Jerusalem, Israel.;Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel (författare)
Hernando, JorgeVall dHebron Inst Oncol, Vall dHebron Univ Hosp, Dept Med Oncol, Barcelona, Spain (författare)
Hervieu, ValerieHosp Civils Lyon, HEH, Lyon, France (författare)
Hofland, JohannesErasmus MC, Dept Internal Med, Endocrinol Sect, ENETS Ctr Excellence, Rotterdam, Netherlands.;Erasmus MC, Erasmus Canc Inst, Rotterdam, Netherlands (författare)
Holmager, PernilleCopenhagen Univ Hosp, Rigshosp, ENETS Neuroendocrine Tumor Ctr Excellence, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Endocrinol, Copenhagen, Denmark (författare)
Inzani, FredianoFdn Policlin Univ A Gemelli IRCCS, Gen Pathol, Dept Woman & Child Hlth Sci & Publ Hlth, Rome, Italy.;Roma European NeuroEndocrine Tumor Soc, Ctr Excellence, Rome, Italy (författare)
Jann, HenningCharite Univ Med Berlin, Hepatol & Gastroenterol, Berlin, Germany (författare)
Jimenez-Fonseca, PaulaHosp Univ Cent Asturias, ISPA, Dept Med Oncol, Oviedo, Spain (författare)
Kacmaz, EnesUniv Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands (författare)
Kaemmerer, DanielZent Klin Bad Berka, Dept Gen & Visceral Surg, Bad Berka, Germany (författare)
Kaltsas, GregoryNatl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece (författare)
Klimàcek, BranislavUppsala universitet,Endokrinkirurgi(Swepub:uu)brakl606 (författare)
Knigge, UlrichCopenhagen Univ Hosp, Rigshosp, ENETS Neuroendocrine Tumor Ctr Excellence, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Endocrinol, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Surg, Copenhagen, Denmark (författare)
Kolasinska-Cwikla, AgnieszkaMaria Sklodowska Curie Natl Res Inst Oncol, Warsaw, Poland (författare)
Kolb, WalterKantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland (författare)
Kos-Kudla, BeataMed Univ Silesia, Dept Endocrinol & Neuroendocrine Neoplasms, Katowice, Poland.;Med Univ Silesia, Dept Endocrinol & Pathophysiol, Katowice, Poland (författare)
Kunze, Catarina AlisaCharite Univ Med Berlin, Inst Pathol, Berlin, Germany.;Free Univ Berlin, Berlin, Germany.;Humboldt Univ, Berlin, Germany (författare)
Landolfi, StefaniaVall dHebron Univ Hosp, Dept Pathol, Barcelona, Spain (författare)
La Rosa, StefanoUniv Lausanne, Inst Pathol, Dept Lab Med & Pathol, Lausanne, Switzerland.;Univ Insubria, Dept Med & Surg, Unit Pathol, Varese, Italy (författare)
Lopez, Carlos LopezHosp Univ Marques de Valdecilla, Dept Med Oncol, IDIVAL, Santander, Spain (författare)
Lorenz, KerstinMartin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany (författare)
Matter, MauriceUniv Lausanne, Dept Visceral Surg, Univ Lausanne Hosp, Lausanne, Switzerland (författare)
Mazal, PeterMed Univ Vienna, Gen Hosp Vienna, Dept Clin Pathol, Vienna, Austria (författare)
Mestre-Alagarda, ClaudiaKings Coll Hosp London, Inst Liver Studies, Histopathol, London, England (författare)
del Burgo, Patricia MoralesHosp Univ Cent Asturias, Dept Pathol, Oviedo, Spain (författare)
van Dijkum, Els J. M. NieveenUniv Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands (författare)
Oleinikov, KiraHebrew Univ Jerusalem, Hadassah Med Org, Neuroendocrine Tumor Unit, ENETS Ctr Excellence,Dept Endocrinol & Metab, Jerusalem, Israel.;Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel (författare)
Orci, Lorenzo A.Geneva Univ Hosp, Div Abdominal Surg, Dept Surg, Geneva, Switzerland (författare)
Panzuto, FrancescoSapienza Univ Rome, Dept Med Surg Sci & Translat Med, Rome, Italy.;St Andrea Univ Hosp, ENETS Ctr Excellence, Digest Dis Unit, Rome, Italy (författare)
Pavel, MarianneFriedrich Alexander Univ Erlangen Nurnberg, Dept Med 1, Erlangen, Germany (författare)
Perrier, MarineUniv Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France (författare)
Reims, Henrik MikaelRigshosp, Oslo Univ Hosp, Dept Pathol, Oslo, Norway (författare)
Rindi, GuidoFdn Policlin Univ A Gemelli IRCCS, Unit Head & Neck Lung & Endocrine Pathol, Dept Woman & Child Hlth Sci & Publ Hlth, Rome, Italy.;Roma European NeuroEndocrine Tumor Soc, Ctr Excellence, Rome, Italy.;Univ Cattolica Sacro Cuore, Dept Life Sci & Publ Hlth, Sect Anat Pathol, Rome, Italy (författare)
Rinke, AnjaUKGM, Dept Gastroenterol & Endocrinol, Marburg, Germany.;Philipps Univ Marburg, Marburg, Germany (författare)
Rinzivillo, MariaSt Andrea Univ Hosp, ENETS Ctr Excellence, Digest Dis Unit, Rome, Italy (författare)
Sagaert, XavierKatholieke Univ Leuven, Translat Cell & Tissue Res, Leuven, Belgium (författare)
Satiroglu, IlkerMartin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany (författare)
Selberherr, AndreasMed Univ Vienna, Dept Gen Surg, Div Visceral Surg, Vienna, Austria (författare)
Siebenhuener, Alexander R.Univ Spital Zurich, Klin Med Onkol & Hamatol, Zurich, Switzerland.;Univ Zurich, Zurich, Switzerland.;Kantonsspital Schaffhausen, Dept Med Onkol, Schaffhausen, Switzerland (författare)
Tesselaar, Margot E. T.Netherlands Canc Inst, Dept Med Oncol, Amsterdam, Netherlands (författare)
Thalhammer, Michael J.Med Univ Graz, Dept Surg, Div Visceral & Transplant Surg, Graz, Austria (författare)
Thiis-Evensen, EspenRigshosp, Oslo Univ Hosp, Dept Gastroenterol, Oslo, Norway (författare)
Toumpanakis, ChristosRoyal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England (författare)
Vandamme, TimonUniv Hosp Antwerp, Edegem, Belgium (författare)
van den Berg, José G.Netherlands Canc Inst, Dept Pathol, Amsterdam, Netherlands (författare)
Vanoli, AlessandroUniv Pavia, Dept Mol Med, Anat Pathol Unit, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Anat Pathol Unit, Pavia, Italy (författare)
van Velthuysen, Marie-Louise F.Erasmus MC, Dept Pathol, Rotterdam, Netherlands (författare)
Verslype, ChrisUniv Hosp Leuven, Clin Digest Oncol, Leuven, Belgium (författare)
Vorburger, Stephan A.Teaching Hosp Emmental, Dept Surg, Burgdorf, Switzerland (författare)
Lugli, AlessandroUniv Bern, Inst Pathol, Bern, Switzerland (författare)
Ramage, JohnUniv Winchester, Winchester, Hants, England.;Hampshire Hosp, Basingstoke, Hants, England (författare)
Zwahlen, MarcelUniv Bern, Inst Social & Prevent Med, Bern, Switzerland (författare)
Perren, AurelUniv Bern, Inst Pathol, Bern, Switzerland (författare)
Kaderli, Reto M.Univ Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, Switzerland (författare)
Univ Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, SwitzerlandUniv Bern, Inst Pathol, Bern, Switzerland (creator_code:org_t)

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Ingår i:The Lancet Oncology: Elsevier24:2, s. 187-1941470-20451474-5488

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Av författaren/redakt...: Nesti, Cedric; Bräutigam, Konst ...; Benavent, Marta; Bernal, Laura; Boharoon, Hessa; Botling, Johan; visa fler...; Bouroumeau, Anto ...; Brcic, Iva; Brunner, Maximil ...; Cadiot, Guillaum ...; Camara, Maria; Christ, Emanuel; Clerici, Thomas; Clift, Ashley K.; Clouston, Hamish; Cobianchi, Loren ...; Cwikla, Jaroslaw ...; Daskalakis, Kosm ...; Frilling, Andrea; Garcia-Carbonero ...; Grozinsky-Glasbe ...; Hernando, Jorge; Hervieu, Valerie; Hofland, Johanne ...; Holmager, Pernil ...; Inzani, Frediano; Jann, Henning; Jimenez-Fonseca, ...; Kacmaz, Enes; Kaemmerer, Danie ...; Kaltsas, Gregory; Klimàcek, Branis ...; Knigge, Ulrich; Kolasinska-Cwikl ...; Kolb, Walter; Kos-Kudla, Beata; Kunze, Catarina ...; Landolfi, Stefan ...; La Rosa, Stefano; Lopez, Carlos Lo ...; Lorenz, Kerstin; Matter, Maurice; Mazal, Peter; Mestre-Alagarda, ...; del Burgo, Patri ...; van Dijkum, Els ...; Oleinikov, Kira; Orci, Lorenzo A.; Panzuto, Frances ...; Pavel, Marianne; Perrier, Marine; Reims, Henrik Mi ...; Rindi, Guido; Rinke, Anja; Rinzivillo, Mari ...; Sagaert, Xavier; Satiroglu, Ilker; Selberherr, Andr ...; Siebenhuener, Al ...; Tesselaar, Margo ...; Thalhammer, Mich ...; Thiis-Evensen, E ...; Toumpanakis, Chr ...; Vandamme, Timon; van den Berg, Jo ...; Vanoli, Alessand ...; van Velthuysen, ...; Verslype, Chris; Vorburger, Steph ...; Lugli, Alessandr ...; Ramage, John; Zwahlen, Marcel; Perren, Aurel; Kaderli, Reto M.; visa färre...

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