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

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

Bräutigam, Konstantin (författare): Univ Bern, Inst Pathol, Bern, Switzerland

Benavent, Marta (författare): Univ Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain

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Bernal, Laura (författare): Univ Hosp Virgen del Rocio, Dept Med Oncol, Inst Biomed Sevilla, Seville, Spain

Boharoon, Hessa (författare): Royal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England

Botling, Johan (författare): Uppsala universitet,Cancerprecisionsmedicin

Bouroumeau, Antonin (författare): Univ Hosp Geneva, Div Clin Pathol, Diagnost Dept, Geneva, Switzerland

Brcic, Iva (författare): Med Univ Graz, Diagnost & Res Inst Pathol, Graz, Austria

Brunner, Maximilian (författare): Friedrich Alexander Univ Erlangen Nurnberg, Dept Surg, Univ Hosp, Erlangen, Germany

Cadiot, Guillaume (författare): Univ Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France

Camara, Maria (författare): UCM, Imas12, Hosp Univ 12 Octubre, Dept Pathol, Madrid, Spain

Christ, Emanuel (författare): Univ Hosp Basel, ENETS Ctr Excellence, Dept Endocrinol Diabetol & Metab, Basel, Switzerland

Clerici, Thomas (författare): Kantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland

Clift, Ashley K. (författare): Imperial Coll London, Dept Surg & Canc, London, England

Clouston, Hamish (författare): Christie NHS Fdn Trust, Colorectal & Peritoneal Oncol Ctr, Manchester, Lancs, England

Cobianchi, Lorenzo (författare): Univ Pavia, Dept Clin Diagnost & Pediat Sci, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Dept Gen Surg, Pavia, Italy

Cwikla, Jaroslaw B. (författare): Indywidualna Specjalistyczna Praktyka Lekarska, Warsaw, Poland

Daskalakis, Kosmas (författare): Natl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece

Frilling, Andrea (författare): Imperial Coll London, Dept Surg & Canc, London, England

Garcia-Carbonero, Rocio (författare): UCM, Imas12, Hosp Univ 12 Octubre, Dept Oncol, Madrid, Spain

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

Hernando, Jorge (författare): Vall dHebron Inst Oncol, Vall dHebron Univ Hosp, Dept Med Oncol, Barcelona, Spain

Hervieu, Valerie (författare): Hosp Civils Lyon, HEH, Lyon, France

Hofland, Johannes (författare): Erasmus MC, Dept Internal Med, Endocrinol Sect, ENETS Ctr Excellence, Rotterdam, Netherlands.;Erasmus MC, Erasmus Canc Inst, Rotterdam, Netherlands

Holmager, Pernille (författare): Copenhagen Univ Hosp, Rigshosp, ENETS Neuroendocrine Tumor Ctr Excellence, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Endocrinol, Copenhagen, Denmark

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

Jann, Henning (författare): Charite Univ Med Berlin, Hepatol & Gastroenterol, Berlin, Germany

Jimenez-Fonseca, Paula (författare): Hosp Univ Cent Asturias, ISPA, Dept Med Oncol, Oviedo, Spain

Kacmaz, Enes (författare): Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands

Kaemmerer, Daniel (författare): Zent Klin Bad Berka, Dept Gen & Visceral Surg, Bad Berka, Germany

Kaltsas, Gregory (författare): Natl & Kapodistrian Univ Athens, ENETS Ctr Excellence, Dept Propaedeut Internal Med 1, Endocrine Unit, Athens, Greece

Klimàcek, Branislav (författare): Uppsala universitet,Endokrinkirurgi

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

Kolasinska-Cwikla, Agnieszka (författare): Maria Sklodowska Curie Natl Res Inst Oncol, Warsaw, Poland

Kolb, Walter (författare): Kantonsspital St Gallen, Klin Allgemein Viszeral Endokrin & Transplantat, St Gallen, Switzerland

Kos-Kudla, Beata (författare): Med Univ Silesia, Dept Endocrinol & Neuroendocrine Neoplasms, Katowice, Poland.;Med Univ Silesia, Dept Endocrinol & Pathophysiol, Katowice, Poland

Kunze, Catarina Alisa (författare): Charite Univ Med Berlin, Inst Pathol, Berlin, Germany.;Free Univ Berlin, Berlin, Germany.;Humboldt Univ, Berlin, Germany

Landolfi, Stefania (författare): Vall dHebron Univ Hosp, Dept Pathol, Barcelona, Spain

La Rosa, Stefano (författare): Univ Lausanne, Inst Pathol, Dept Lab Med & Pathol, Lausanne, Switzerland.;Univ Insubria, Dept Med & Surg, Unit Pathol, Varese, Italy

Lopez, Carlos Lopez (författare): Hosp Univ Marques de Valdecilla, Dept Med Oncol, IDIVAL, Santander, Spain

Lorenz, Kerstin (författare): Martin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany

Matter, Maurice (författare): Univ Lausanne, Dept Visceral Surg, Univ Lausanne Hosp, Lausanne, Switzerland

Mazal, Peter (författare): Med Univ Vienna, Gen Hosp Vienna, Dept Clin Pathol, Vienna, Austria

Mestre-Alagarda, Claudia (författare): Kings Coll Hosp London, Inst Liver Studies, Histopathol, London, England

del Burgo, Patricia Morales (författare): Hosp Univ Cent Asturias, Dept Pathol, Oviedo, Spain

van Dijkum, Els J. M. Nieveen (författare): Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands

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

Orci, Lorenzo A. (författare): Geneva Univ Hosp, Div Abdominal Surg, Dept Surg, Geneva, Switzerland

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

Pavel, Marianne (författare): Friedrich Alexander Univ Erlangen Nurnberg, Dept Med 1, Erlangen, Germany

Perrier, Marine (författare): Univ Reims, CHU Reims, Serv Hepatogastroenterol & Oncol Digest, Reims, France

Reims, Henrik Mikael (författare): Rigshosp, Oslo Univ Hosp, Dept Pathol, Oslo, Norway

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

Rinke, Anja (författare): UKGM, Dept Gastroenterol & Endocrinol, Marburg, Germany.;Philipps Univ Marburg, Marburg, Germany

Rinzivillo, Maria (författare): St Andrea Univ Hosp, ENETS Ctr Excellence, Digest Dis Unit, Rome, Italy

Sagaert, Xavier (författare): Katholieke Univ Leuven, Translat Cell & Tissue Res, Leuven, Belgium

Satiroglu, Ilker (författare): Martin Luther Univ Halle Wittenberg, Dept Visceral Vascular & Endocrine Surg, Halle, Germany

Selberherr, Andreas (författare): Med Univ Vienna, Dept Gen Surg, Div Visceral Surg, Vienna, Austria

Siebenhuener, Alexander R. (författare): Univ Spital Zurich, Klin Med Onkol & Hamatol, Zurich, Switzerland.;Univ Zurich, Zurich, Switzerland.;Kantonsspital Schaffhausen, Dept Med Onkol, Schaffhausen, Switzerland

Tesselaar, Margot E. T. (författare): Netherlands Canc Inst, Dept Med Oncol, Amsterdam, Netherlands

Thalhammer, Michael J. (författare): Med Univ Graz, Dept Surg, Div Visceral & Transplant Surg, Graz, Austria

Thiis-Evensen, Espen (författare): Rigshosp, Oslo Univ Hosp, Dept Gastroenterol, Oslo, Norway

Toumpanakis, Christos (författare): Royal Free Hosp London, ENETS Ctr Excellence, Neuroendocrine Tumour Unit, London, England

Vandamme, Timon (författare): Univ Hosp Antwerp, Edegem, Belgium

van den Berg, José G. (författare): Netherlands Canc Inst, Dept Pathol, Amsterdam, Netherlands

Vanoli, Alessandro (författare): Univ Pavia, Dept Mol Med, Anat Pathol Unit, Pavia, Italy.;IRCCS Policlin San Matteo Fdn, Anat Pathol Unit, Pavia, Italy

van Velthuysen, Marie-Louise F. (författare): Erasmus MC, Dept Pathol, Rotterdam, Netherlands

Verslype, Chris (författare): Univ Hosp Leuven, Clin Digest Oncol, Leuven, Belgium

Vorburger, Stephan A. (författare): Teaching Hosp Emmental, Dept Surg, Burgdorf, Switzerland

Lugli, Alessandro (författare): Univ Bern, Inst Pathol, Bern, Switzerland

Ramage, John (författare): Univ Winchester, Winchester, Hants, England.;Hampshire Hosp, Basingstoke, Hants, England

Zwahlen, Marcel (författare): Univ Bern, Inst Social & Prevent Med, Bern, Switzerland

Perren, Aurel (författare): Univ Bern, Inst Pathol, Bern, Switzerland

Kaderli, Reto M. (författare): Univ Hosp Bern, Inselspital, Dept Visceral Surg & Med, CH-3010 Bern, Switzerland

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Elsevier, 2023
2023
Engelska.
Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 24:2, s. 187-194

Relaterad länk:: https://www.scienced...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

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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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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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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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