Hua Ye1, Hong Liu Xu2, Qijun Shen3, Qi Zheng1, Ping Chen4. 1. Department of Gastrointestinal and Hernia Ward, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China. 2. Medical School of Ningbo University, Ningbo, Zhejiang, China. 3. Department of Health Statistics, Medical School of Ningbo University, Ningbo, Zhejiang, China. 4. Department of Gastrointestinal and Hernia Ward, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China. Electronic address: 108156968@qq.com.
Abstract
BACKGROUND: Whether primary tumor resection is beneficial in patients with metastatic nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs) remains unclear. This study aimed to investigate whether palliative resection of primary tumor affected the survival of patients with stage IV NF-pNETs. METHODS: We collected data from patients with stage IV NF-pNET registered in the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Risk-adjusted Cox proportional hazard regression analysis and propensity score-matched analysis were used to analyze overall survival (OS) and cancer-specific survival (CSS) of patients. RESULTS: In total, 1974 stage IV NF-pNETs patients were identified, of whom 392 (19.9%) received palliative primary tumor resection. The latter exhibited significantly prolonged OS (hazard ratio = 2.514, 95% confidence interval: 2.081-3.037, P < 0.001) and CSS (hazard ratio = 2.634, 95% confidence interval: 2.159-3.213, P < 0.001) in multivariate Cox regression analysis. According to propensity score-matched results, patients without primary tumor resection had worse OS and CSS. CONCLUSIONS: This study demonstrates that there is a significant correlation between palliative resection of primary tumor and survival benefit. Therefore, resection could be considered as an additional treatment option in this specific patient population.
BACKGROUND: Whether primary tumor resection is beneficial in patients with metastatic nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs) remains unclear. This study aimed to investigate whether palliative resection of primary tumor affected the survival of patients with stage IV NF-pNETs. METHODS: We collected data from patients with stage IV NF-pNET registered in the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Risk-adjusted Cox proportional hazard regression analysis and propensity score-matched analysis were used to analyze overall survival (OS) and cancer-specific survival (CSS) of patients. RESULTS: In total, 1974 stage IV NF-pNETs patients were identified, of whom 392 (19.9%) received palliative primary tumor resection. The latter exhibited significantly prolonged OS (hazard ratio = 2.514, 95% confidence interval: 2.081-3.037, P < 0.001) and CSS (hazard ratio = 2.634, 95% confidence interval: 2.159-3.213, P < 0.001) in multivariate Cox regression analysis. According to propensity score-matched results, patients without primary tumor resection had worse OS and CSS. CONCLUSIONS: This study demonstrates that there is a significant correlation between palliative resection of primary tumor and survival benefit. Therefore, resection could be considered as an additional treatment option in this specific patient population.
Authors: James R Howe; Nipun B Merchant; Claudius Conrad; Xavier M Keutgen; Julie Hallet; Jeffrey A Drebin; Rebecca M Minter; Terry C Lairmore; Jennifer F Tseng; Herbert J Zeh; Steven K Libutti; Gagandeep Singh; Jeffrey E Lee; Thomas A Hope; Michelle K Kim; Yusuf Menda; Thorvardur R Halfdanarson; Jennifer A Chan; Rodney F Pommier Journal: Pancreas Date: 2020-01 Impact factor: 3.327