학술논문
Survival of patients managed in France for duodenal neuroendocrine tumors (D-NET): a 20-year multicenter cohort study from the GTE group: a cohort study.
Document Type
Academic Journal
Author
Mekkan-Bouv Hez M; Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex.; Derbey L; Gastro-entérologie, hépatologie et oncologie médicale, Hôpital Édouard-Herriot, Hospices civils de Lyon, Lyon.; de Mestier L; Université de Paris, Department of Pancreatology and Digestive Oncology, Hospital Beaujon (APHP.Nord), Clichy.; D L; Université de Paris, Department of Pancreatology and Digestive Oncology, Hospital Beaujon (APHP.Nord), Clichy.; Walter T; Gastro-entérologie, hépatologie et oncologie médicale, Hôpital Édouard-Herriot, Hospices civils de Lyon, Lyon.; Perrier M; Hépatogastro-entérologie et oncologie digestive, CHU de Reims.; Cadiot G; Hépatogastro-entérologie et oncologie digestive, CHU de Reims.; Goichot B; Service de Médecine interne, Endocrinologie et Nutrition, Pôle MIRNED , Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, Strasbourg Cedex.; Pracht M; Oncologie médicale, Centre Eugène Marquis, 5 Rue Bataille Flandres-Dunkerque.; Lièvre A; Gastro-entérologie, CHU Pontchaillou, Université Rennes, Inserm U1242, COSS (Chemistry Oncogenesis Stress Signaling), Rennes.; Coriat R; Gastro-entérologie et hépatologie. CHU Cochin, AP-HP.; Valancot S; Département de Chirurgie Digestive, CHU Toulouse.; Guimbaud R; Oncologie médicale digestive gynecologique, CHU Toulouse.; Carrere N; Département de Chirurgie Digestive, CHU Toulouse.; Bacoeur-Ouzillou O; Chirurgie viscérale et digestive, CHU Clermont-Ferrand, Clermont-Ferrand.; Belleannée G; Service de Pathologie, CHU de Bordeaux, Bordeaux.; Smith D; Oncologie Digestive, CHU de Bordeaux, Service d'Hépato-Gastroentérologie et d'Oncologie Digestive, Centre Médico-Chirurgical Magellan, Hôpital Haut-Lévèque, Avenue Magellan, 33604 PESSAC cedex.; Laboureau S; Département d'endocrinologie-diabétologie et nutrition, CHU Angers.; Hescot S; Endocrinologie et Métabolismes, Institut Curie, 26, Rue d'Ulm, Paris.; Julie C; EA4340 Université Versailles- Saint-Quentin-en-Yvelines, Anatomie Pathologique, Hôpital Ambroise Paré, APHP.; Teissier MP; Endocrinologie-Diabète-Maladies métaboliques-CHU de Limoges.; Thereaux J; Chirurgie Digestive, CHU de Brest.; Ferru A; Cancérologie médicale, CHU de Poitiers.; Evrard C; Cancérologie médicale, CHU de Poitiers.; Mathonnet M; Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex.; Christou N; Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex.
Source
Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Duodenal neuroendocrine tumours (D-NETs) have a low incidence; however, their diagnosis has been increasing. Features such as tumour location, size, type, histological grade, and stage were used to adapt the treatment to either endoscopic (ER) or surgical (SR) resections. There is no consensus regarding the definitive treatment. The authors' study aimed to describe the management of non-metastatic, well-differentiated D-NETs in France and its impact on patient survival.
Methods: A registry-based multicenter study using prospectively collected data between 2000 and 2019, including all patients managed for non-metastatic G1 and G2 D-NETs, was conducted in the GTE group.
Results: A total of 153 patients were included. Fifty-eight benefited from an ER, and 95 had an SR. No difference in recurrence-free survival (RFS) was observed regardless of treatment type. There was no significant difference between the two groups (ER vs. SR) in terms of location, size, grade, or lymphadenopathy, regardless of the type of incomplete resection performed or regarding the pre-therapeutic assessment of lymph node invasion in imaging. The surgery allowed for significantly more complete resection (patients with R1 resection in the SR group: 9 vs. 14 in the ER group, P<0.001). Among the 51 patients with positive lymph node dissection after SR, tumour size was less than or equal to 1 cm in 25 cases. Surgical complications were more numerous (P=0.001). In the sub-group analysis of G1-G2 D-NETs between 11 and 19 mm, there was no significant difference in grade (P=0.977) and location (P=0.617) between the two groups (ER vs. SR). No significant difference was found in both morphological and functional imaging, focusing on the pre-therapeutic assessment of lymph node invasion (P=0.387).
Conclusion: Regardless of the resection type (ER or SR) of G1-G2 non-metastatic D-NETs, as well as the type of management of incomplete resection, which was greater in the ER group, long-term survival results were similar between ER and SR. Organ preservation seems to be the best choice owing to the slow evolution of these tumours.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Methods: A registry-based multicenter study using prospectively collected data between 2000 and 2019, including all patients managed for non-metastatic G1 and G2 D-NETs, was conducted in the GTE group.
Results: A total of 153 patients were included. Fifty-eight benefited from an ER, and 95 had an SR. No difference in recurrence-free survival (RFS) was observed regardless of treatment type. There was no significant difference between the two groups (ER vs. SR) in terms of location, size, grade, or lymphadenopathy, regardless of the type of incomplete resection performed or regarding the pre-therapeutic assessment of lymph node invasion in imaging. The surgery allowed for significantly more complete resection (patients with R1 resection in the SR group: 9 vs. 14 in the ER group, P<0.001). Among the 51 patients with positive lymph node dissection after SR, tumour size was less than or equal to 1 cm in 25 cases. Surgical complications were more numerous (P=0.001). In the sub-group analysis of G1-G2 D-NETs between 11 and 19 mm, there was no significant difference in grade (P=0.977) and location (P=0.617) between the two groups (ER vs. SR). No significant difference was found in both morphological and functional imaging, focusing on the pre-therapeutic assessment of lymph node invasion (P=0.387).
Conclusion: Regardless of the resection type (ER or SR) of G1-G2 non-metastatic D-NETs, as well as the type of management of incomplete resection, which was greater in the ER group, long-term survival results were similar between ER and SR. Organ preservation seems to be the best choice owing to the slow evolution of these tumours.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)