Fabio Bagante1, Gaya Spolverato1, Katiuscha Merath2, Lauren McLendon Postlewait3, George A Poultsides4, Matthew G Mullen5, Todd W Bauer5, Ryan C Fields6, Jorge Lamelas7, Hugo P Marques7, Luca Aldrighetti8, Thuy Tran4, Shishir K Maithel3, Timothy M Pawlik9. 1. Department of Surgery, University of Verona, Verona, Italy. 2. Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland. 3. Department of Surgery, Emory University, Atlanta, Georgia. 4. Department of Surgery, School of Medicine, Stanford University, Stanford, California. 5. Department of Surgery, University of Virginia, Charlottesville, Virginia. 6. Department of Surgery, School of Medicine, Washington University, St Louis, Missouri. 7. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal. 8. Department of Surgery, Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy. 9. Division of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio.
Abstract
BACKGROUND AND OBJECTIVE: Neuroendocrine liver metastasis tumors (NELM) are a heterogeneous group of neoplasms with varied histologic features and a wide range of clinical behaviors. We aimed to identify the fraction of patients cured after liver surgery for NELM. METHODS: Cure fraction models were used to analyze 376 patients who underwent hepatectomy with curative intent for NELM. RESULTS: The median and 5-year disease-free survival (DFS) were 4.5 years and 46%, respectively. The probability of being cured from NELM by liver surgery was 44%; the time to cure was 5.1 years. In a multivariable cure model, type of neuroendocrine tumor (NET), grade of tumor differentiation, and rate of liver involvement resulted as independent predictors of cure. The cure fraction for patients with well differentiated NELM from gastrointestinal NET or a functional pancreatic NET, and with <50% of liver-involvement was 95%. Patients who had moderately/poorly differentiated NELM from a non-functional pancreatic NET, and with <50% of liver-involvement was 43%. In the presence of all the three unfavorable prognostic factors (nonfunctional PNET, liver involvement >50%, moderately/poorly differentiation), the cure fraction was 8%. CONCLUSIONS: Statistical cure after surgery for NELM is possible, and allow for a more accurate prediction of long-term outcome among patients with NELM undergoing liver resection.
BACKGROUND AND OBJECTIVE:Neuroendocrine liver metastasis tumors (NELM) are a heterogeneous group of neoplasms with varied histologic features and a wide range of clinical behaviors. We aimed to identify the fraction of patients cured after liver surgery for NELM. METHODS: Cure fraction models were used to analyze 376 patients who underwent hepatectomy with curative intent for NELM. RESULTS: The median and 5-year disease-free survival (DFS) were 4.5 years and 46%, respectively. The probability of being cured from NELM by liver surgery was 44%; the time to cure was 5.1 years. In a multivariable cure model, type of neuroendocrine tumor (NET), grade of tumor differentiation, and rate of liver involvement resulted as independent predictors of cure. The cure fraction for patients with well differentiated NELM from gastrointestinal NET or a functional pancreatic NET, and with <50% of liver-involvement was 95%. Patients who had moderately/poorly differentiated NELM from a non-functional pancreatic NET, and with <50% of liver-involvement was 43%. In the presence of all the three unfavorable prognostic factors (nonfunctional PNET, liver involvement >50%, moderately/poorly differentiation), the cure fraction was 8%. CONCLUSIONS: Statistical cure after surgery for NELM is possible, and allow for a more accurate prediction of long-term outcome among patients with NELM undergoing liver resection.
Authors: Xu-Feng Zhang; Eliza W Beal; Jeffery Chakedis; Yi Lv; Fabio Bagante; Luca Aldrighetti; George A Poultsides; Todd W Bauer; Ryan C Fields; Shishir Kumar Maithel; Hugo P Marques; Matthew Weiss; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-07-20 Impact factor: 3.452
Authors: Fabio Bagante; Gaya Spolverato; Matthew Weiss; Sorin Alexandrescu; Hugo P Marques; Luca Aldrighetti; Shishir K Maithel; Carlo Pulitano; Todd W Bauer; Feng Shen; George A Poultsides; Oliver Soubrane; Guillaume Martel; B Groot Koerkamp; Alfredo Guglielmi; Endo Itaru; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-08-24 Impact factor: 3.452
Authors: Gaya Spolverato; Fabio Bagante; Luca Aldrighetti; George Poultsides; Todd W Bauer; Ryan C Field; Hugo P Marques; Matthew Weiss; Shishir K Maithel; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-07-25 Impact factor: 3.452
Authors: John F Tierney; Jennifer Poirier; Sitaram Chivukula; Sam G Pappas; Martin Hertl; Erik Schadde; Xavier Keutgen Journal: Int J Endocrinol Date: 2019-03-12 Impact factor: 3.257