학술논문

Recurrence Patterns After Surgical Resection of Gastroenteropancreatic Neuroendocrine Tumors: Analysis From the National Comprehensive Cancer Network Oncology Outcomes Database.
Document Type
article
Source
Pancreas. 50(4)
Subject
Humans
Neuroendocrine Tumors
Intestinal Neoplasms
Stomach Neoplasms
Pancreatic Neoplasms
Neoplasm Recurrence
Local
Databases
Factual
Adult
Aged
Aged
80 and over
Middle Aged
United States
Female
Male
Young Adult
Kaplan-Meier Estimate
Outcome Assessment
Health Care
Rare Diseases
Cancer
Colo-Rectal Cancer
Digestive Diseases
Patient Safety
neuroendocrine tumors
recurrence
surveillance
guidelines
Clinical Sciences
Gastroenterology & Hepatology
Language
Abstract
ObjectiveCurrent National Comprehensive Cancer Network guidelines for gastroenteropancreatic neuroendocrine tumors (GEPNETs) recommend complete (R0) surgical resection of the primary tumor and metastases, if feasible. However, large multicenter studies of recurrence patterns of GEPNETs after resection have not been performed.MethodsPatients 18 years or older who presented to 7 participating National Comprehensive Cancer Network institutions between 2004 and 2008 with a new diagnosis of a small bowel, pancreas, or colon/rectum neuroendocrine tumor (NET) and underwent R0 resection of the primary tumor, and synchronous metastases, if present, were included in this analysis. Descriptive statistics and Kaplan-Meier estimates were used to calculate recurrence rates and time-associated end points, respectively.ResultsOf 294 patients with GEPNETs, 50% were male, 88% were White, and 99% had Eastern Cooperative Oncology Group performance status 0 to 1. The median age was 55 years (range, 20-90). The median follow-up time from R0 resection was 62.1 months. Recurrence rates were 18% in small bowel NETs (n = 110), 26% in pancreatic NETs (n = 141), and 10% in colon/rectum NETs (n = 50). The frequency of surveillance imaging was highly variable.ConclusionsR0 resection was associated with variable risk of recurrence across subtypes. Further research to inform refinement of guidelines for the appropriate duration of surveillance after R0 resection is needed.