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Hemicolectomy versu...
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, Cedric (författare)
- Univ Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, Switzerland
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- Bräutigam, Konstantin (författare)
- Univ Bern, Inst Pathol, Bern, Switzerland
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- Benavent, Marta (författare)
- Univ Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain
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visa fler...
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- Bernal, Laura (författare)
- Univ Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain
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- Boharoon, Hessa (författare)
- Royal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England
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- Botling, Johan (författare)
- Uppsala universitet,Cancerprecisionsmedicin
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- Bouroumeau, Antonin (författare)
- Univ Hosp Geneva, Div Clin Pathol, Diagnost Dept, Geneva, Switzerland
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- Brcic, Iva (författare)
- Med Univ Graz, Diagnost & Res Inst Pathol, Graz, Austria
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- Brunner, Maximilian (författare)
- Friedrich Alexander Univ Erlangen Nurnberg, Dept Surg, Univ Hosp, Erlangen, Germany
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- Cadiot, Guillaume (författare)
- Univ Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France
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- Camara, Maria (författare)
- UCM, Imas12, Hosp Univ 12 Octubre, Dept Pathol, Madrid, Spain
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- Christ, Emanuel (författare)
- Univ Hosp Basel, ENETS Ctr Excellence, Dept Endocrinol Diabetol & Metab, Basel, Switzerland
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- Clerici, Thomas (författare)
- Kantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland
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- Clift, Ashley K. (författare)
- Imperial Coll London, Dept Surg & Canc, London, England
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- Clouston, Hamish (författare)
- Christie NHS Fdn Trust, Colorectal & Peritoneal Oncol Ctr, Manchester, Lancs, England
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- Cobianchi, Lorenzo (författare)
- Univ Pavia, Dept Clin Diagnost & Pediat Sci, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Dept Gen Surg, Pavia, Italy
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- Cwikla, Jaroslaw B. (författare)
- Indywidualna Specjalistyczna Praktyka Lekarska, Warsaw, Poland
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- Daskalakis, Kosmas (författare)
- Natl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece
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- Frilling, Andrea (författare)
- Imperial Coll London, Dept Surg & Canc, London, England
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- Garcia-Carbonero, Rocio (författare)
- UCM, Imas12, Hosp Univ 12 Octubre, Dept Oncol, Madrid, Spain
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- Grozinsky-Glasberg, Simona (författare)
- Hebrew Univ Jerusalem, Hadassah Med Org, Neuroendocrine Tumor Unit, ENETS Ctr Excellence,Dept Endocrinol & Metab, Jerusalem, Israel.;Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel
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- Hernando, Jorge (författare)
- Vall dHebron Inst Oncol, Vall dHebron Univ Hosp, Dept Med Oncol, Barcelona, Spain
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- Hervieu, Valerie (författare)
- Hosp Civils Lyon, HEH, Lyon, France
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- Hofland, Johannes (författare)
- Erasmus MC, Dept Internal Med, Endocrinol Sect, ENETS Ctr Excellence, Rotterdam, Netherlands.;Erasmus MC, Erasmus Canc Inst, Rotterdam, Netherlands
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- Holmager, Pernille (författare)
- Copenhagen Univ Hosp, Rigshosp, ENETS Neuroendocrine Tumor Ctr Excellence, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Endocrinol, Copenhagen, Denmark
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- Inzani, Frediano (författare)
- Fdn 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
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- Jann, Henning (författare)
- Charite Univ Med Berlin, Hepatol & Gastroenterol, Berlin, Germany
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- Jimenez-Fonseca, Paula (författare)
- Hosp Univ Cent Asturias, ISPA, Dept Med Oncol, Oviedo, Spain
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- Kacmaz, Enes (författare)
- Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands
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- Kaemmerer, Daniel (författare)
- Zent Klin Bad Berka, Dept Gen & Visceral Surg, Bad Berka, Germany
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- Kaltsas, Gregory (författare)
- Natl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece
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- Klimàcek, Branislav (författare)
- Uppsala universitet,Endokrinkirurgi
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- Knigge, Ulrich (författare)
- Copenhagen 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
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- Kolasinska-Cwikla, Agnieszka (författare)
- Maria Sklodowska Curie Natl Res Inst Oncol, Warsaw, Poland
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- Kolb, Walter (författare)
- Kantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland
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- Kos-Kudla, Beata (författare)
- Med Univ Silesia, Dept Endocrinol & Neuroendocrine Neoplasms, Katowice, Poland.;Med Univ Silesia, Dept Endocrinol & Pathophysiol, Katowice, Poland
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- Kunze, Catarina Alisa (författare)
- Charite Univ Med Berlin, Inst Pathol, Berlin, Germany.;Free Univ Berlin, Berlin, Germany.;Humboldt Univ, Berlin, Germany
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- Landolfi, Stefania (författare)
- Vall dHebron Univ Hosp, Dept Pathol, Barcelona, Spain
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- La Rosa, Stefano (författare)
- Univ Lausanne, Inst Pathol, Dept Lab Med & Pathol, Lausanne, Switzerland.;Univ Insubria, Dept Med & Surg, Unit Pathol, Varese, Italy
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- Lopez, Carlos Lopez (författare)
- Hosp Univ Marques de Valdecilla, Dept Med Oncol, IDIVAL, Santander, Spain
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- Lorenz, Kerstin (författare)
- Martin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany
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- Matter, Maurice (författare)
- Univ Lausanne, Dept Visceral Surg, Univ Lausanne Hosp, Lausanne, Switzerland
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- Mazal, Peter (författare)
- Med Univ Vienna, Gen Hosp Vienna, Dept Clin Pathol, Vienna, Austria
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- Mestre-Alagarda, Claudia (författare)
- Kings Coll Hosp London, Inst Liver Studies, Histopathol, London, England
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- del Burgo, Patricia Morales (författare)
- Hosp Univ Cent Asturias, Dept Pathol, Oviedo, Spain
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- van Dijkum, Els J. M. Nieveen (författare)
- Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands
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- Oleinikov, Kira (författare)
- Hebrew Univ Jerusalem, Hadassah Med Org, Neuroendocrine Tumor Unit, ENETS Ctr Excellence,Dept Endocrinol & Metab, Jerusalem, Israel.;Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel
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- Orci, Lorenzo A. (författare)
- Geneva Univ Hosp, Div Abdominal Surg, Dept Surg, Geneva, Switzerland
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- Panzuto, Francesco (författare)
- Sapienza Univ Rome, Dept Med Surg Sci & Translat Med, Rome, Italy.;St Andrea Univ Hosp, ENETS Ctr Excellence, Digest Dis Unit, Rome, Italy
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- Pavel, Marianne (författare)
- Friedrich Alexander Univ Erlangen Nurnberg, Dept Med 1, Erlangen, Germany
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- Perrier, Marine (författare)
- Univ Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France
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- Reims, Henrik Mikael (författare)
- Rigshosp, Oslo Univ Hosp, Dept Pathol, Oslo, Norway
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- Rindi, Guido (författare)
- Fdn 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
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- Rinke, Anja (författare)
- UKGM, Dept Gastroenterol & Endocrinol, Marburg, Germany.;Philipps Univ Marburg, Marburg, Germany
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- Rinzivillo, Maria (författare)
- St Andrea Univ Hosp, ENETS Ctr Excellence, Digest Dis Unit, Rome, Italy
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- Sagaert, Xavier (författare)
- Katholieke Univ Leuven, Translat Cell & Tissue Res, Leuven, Belgium
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- Satiroglu, Ilker (författare)
- Martin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany
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- Selberherr, Andreas (författare)
- Med Univ Vienna, Dept Gen Surg, Div Visceral Surg, Vienna, Austria
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- Siebenhuener, Alexander R. (författare)
- Univ Spital Zurich, Klin Med Onkol & Hamatol, Zurich, Switzerland.;Univ Zurich, Zurich, Switzerland.;Kantonsspital Schaffhausen, Dept Med Onkol, Schaffhausen, Switzerland
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- Tesselaar, Margot E. T. (författare)
- Netherlands Canc Inst, Dept Med Oncol, Amsterdam, Netherlands
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- Thalhammer, Michael J. (författare)
- Med Univ Graz, Dept Surg, Div Visceral & Transplant Surg, Graz, Austria
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- Thiis-Evensen, Espen (författare)
- Rigshosp, Oslo Univ Hosp, Dept Gastroenterol, Oslo, Norway
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- Toumpanakis, Christos (författare)
- Royal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England
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- Vandamme, Timon (författare)
- Univ Hosp Antwerp, Edegem, Belgium
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- van den Berg, José G. (författare)
- Netherlands Canc Inst, Dept Pathol, Amsterdam, Netherlands
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- Vanoli, Alessandro (författare)
- Univ Pavia, Dept Mol Med, Anat Pathol Unit, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Anat Pathol Unit, Pavia, Italy
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- van Velthuysen, Marie-Louise F. (författare)
- Erasmus MC, Dept Pathol, Rotterdam, Netherlands
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- Verslype, Chris (författare)
- Univ Hosp Leuven, Clin Digest Oncol, Leuven, Belgium
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- Vorburger, Stephan A. (författare)
- Teaching Hosp Emmental, Dept Surg, Burgdorf, Switzerland
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- Lugli, Alessandro (författare)
- Univ Bern, Inst Pathol, Bern, Switzerland
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- Ramage, John (författare)
- Univ Winchester, Winchester, Hants, England.;Hampshire Hosp, Basingstoke, Hants, England
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- Zwahlen, Marcel (författare)
- Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
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- Perren, Aurel (författare)
- Univ Bern, Inst Pathol, Bern, Switzerland
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- Kaderli, Reto M. (författare)
- Univ Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, Switzerland
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 24:2, s. 187-194
- Relaterad länk:
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https://www.scienced...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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Nesti, Cedric
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Benavent, Marta
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Bernal, Laura
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Boharoon, Hessa
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Botling, Johan
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Camara, Maria
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Christ, Emanuel
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Clerici, Thomas
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Clift, Ashley K.
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Clouston, Hamish
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Cobianchi, Loren ...
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Cwikla, Jaroslaw ...
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Daskalakis, Kosm ...
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Frilling, Andrea
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Garcia-Carbonero ...
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Grozinsky-Glasbe ...
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Hernando, Jorge
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Hervieu, Valerie
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Hofland, Johanne ...
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Holmager, Pernil ...
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Inzani, Frediano
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Jann, Henning
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Jimenez-Fonseca, ...
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Kacmaz, Enes
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Kaemmerer, Danie ...
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Kaltsas, Gregory
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Klimàcek, Branis ...
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Knigge, Ulrich
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Kolasinska-Cwikl ...
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Kolb, Walter
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Kos-Kudla, Beata
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Kunze, Catarina ...
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Landolfi, Stefan ...
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La Rosa, Stefano
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Lopez, Carlos Lo ...
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Lorenz, Kerstin
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Matter, Maurice
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Mazal, Peter
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Mestre-Alagarda, ...
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del Burgo, Patri ...
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van Dijkum, Els ...
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Oleinikov, Kira
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Orci, Lorenzo A.
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Panzuto, Frances ...
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Pavel, Marianne
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Perrier, Marine
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Reims, Henrik Mi ...
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Rindi, Guido
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Rinke, Anja
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Rinzivillo, Mari ...
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Sagaert, Xavier
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Satiroglu, Ilker
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Selberherr, Andr ...
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Siebenhuener, Al ...
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Tesselaar, Margo ...
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Thalhammer, Mich ...
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Thiis-Evensen, E ...
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Toumpanakis, Chr ...
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Vandamme, Timon
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van den Berg, Jo ...
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Vanoli, Alessand ...
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van Velthuysen, ...
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Verslype, Chris
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Vorburger, Steph ...
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Lugli, Alessandr ...
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Ramage, John
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Zwahlen, Marcel
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Perren, Aurel
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Kaderli, Reto M.
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