Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases

Anna Nießen; Frank Bergmann; Ulf Hinz; Simon Schimmack; Thilo Hackert; Markus W Büchler; Oliver Strobel

doi:10.1016/j.ejso.2020.01.030

Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases

Standard

Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases. / Nießen, Anna; Bergmann, Frank; Hinz, Ulf; Schimmack, Simon; Hackert, Thilo; Büchler, Markus W; Strobel, Oliver.

In: EJSO-EUR J SURG ONC, Vol. 46, No. 6, 06.2020, p. 1088-1096.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Nießen, A, Bergmann, F, Hinz, U, Schimmack, S, Hackert, T, Büchler, MW & Strobel, O 2020, 'Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases', EJSO-EUR J SURG ONC, vol. 46, no. 6, pp. 1088-1096. https://doi.org/10.1016/j.ejso.2020.01.030

APA

Nießen, A., Bergmann, F., Hinz, U., Schimmack, S., Hackert, T., Büchler, M. W., & Strobel, O. (2020). Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases. EJSO-EUR J SURG ONC, 46(6), 1088-1096. https://doi.org/10.1016/j.ejso.2020.01.030

Vancouver

Nießen A, Bergmann F, Hinz U, Schimmack S, Hackert T, Büchler MW et al. Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases. EJSO-EUR J SURG ONC. 2020 Jun;46(6):1088-1096. https://doi.org/10.1016/j.ejso.2020.01.030

Bibtex

@article{ff0d7b93dfec418987e9a9c16b80a845,

title = "Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases",

abstract = "BACKGROUND: Clinical management of duodenal neuroendocrine neoplasms (dNEN) is controversial. The aim of this study was to assess the outcome of surgical management and to identify risk factors for metastatic disease.METHODS: Patients undergoing surgery for dNEN were retrospectively analysed. Clinicopathologic features, perioperative outcome and survival were assessed. A literature review with focus on risk factors for metastatic disease was additionally performed.RESULTS: 24 patients were identified. Out of 22 patients presenting with their primary tumour, 20 patients underwent curative resection and 18 patients received curative resection with systematic lymphadenectomy. 17 patients underwent formal oncological resection. Surgical mortality was 1 out of 24 patients. The 5-year overall survival rate was 67% in the entire cohort, 71% in patients undergoing resection for their primary tumour, 72% for patients undergoing curative resection with systematic lymphadenectomy, 75% for pN0 and 70% for pN1 tumours. Lymph node metastases were identified in 15 patients undergoing systematic lymphadenectomy, including 9 of 14 patients with tumours smaller than 2 cm, and 6 of 10 patients with G1 tumours. Literature review confirmed a high risk of metastases in small (58%) or G1 (24%) tumours. Tumour grade and angioinvasion were significantly associated with overall and disease-free survival.CONCLUSION: Even well differentiated or small dNEN harbour a considerable risk of metastases. These data challenge the concepts of surveillance, local resection and endoscopic management for dNEN based on size and grading. Angioinvasion was identified as a strong negative predictor of overall and disease-free survival in dNEN.",

keywords = "Aged, Digestive System Surgical Procedures/methods, Duodenal Neoplasms/pathology, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Neuroendocrine Tumors/diagnosis, Retrospective Studies, Risk Factors",

author = "Anna Nie{\ss}en and Frank Bergmann and Ulf Hinz and Simon Schimmack and Thilo Hackert and B{\"u}chler, {Markus W} and Oliver Strobel",

year = "2020",

month = jun,

doi = "10.1016/j.ejso.2020.01.030",

language = "English",

volume = "46",

pages = "1088--1096",

journal = "EJSO-EUR J SURG ONC",

issn = "0748-7983",

publisher = "W.B. Saunders Ltd",

number = "6",

}

RIS

TY - JOUR

T1 - Surgical resection for duodenal neuroendocrine neoplasia: Outcome, prognostic factors and risk of metastases

AU - Nießen, Anna

AU - Bergmann, Frank

AU - Hinz, Ulf

AU - Schimmack, Simon

AU - Hackert, Thilo

AU - Büchler, Markus W

AU - Strobel, Oliver

PY - 2020/6

Y1 - 2020/6

N2 - BACKGROUND: Clinical management of duodenal neuroendocrine neoplasms (dNEN) is controversial. The aim of this study was to assess the outcome of surgical management and to identify risk factors for metastatic disease.METHODS: Patients undergoing surgery for dNEN were retrospectively analysed. Clinicopathologic features, perioperative outcome and survival were assessed. A literature review with focus on risk factors for metastatic disease was additionally performed.RESULTS: 24 patients were identified. Out of 22 patients presenting with their primary tumour, 20 patients underwent curative resection and 18 patients received curative resection with systematic lymphadenectomy. 17 patients underwent formal oncological resection. Surgical mortality was 1 out of 24 patients. The 5-year overall survival rate was 67% in the entire cohort, 71% in patients undergoing resection for their primary tumour, 72% for patients undergoing curative resection with systematic lymphadenectomy, 75% for pN0 and 70% for pN1 tumours. Lymph node metastases were identified in 15 patients undergoing systematic lymphadenectomy, including 9 of 14 patients with tumours smaller than 2 cm, and 6 of 10 patients with G1 tumours. Literature review confirmed a high risk of metastases in small (58%) or G1 (24%) tumours. Tumour grade and angioinvasion were significantly associated with overall and disease-free survival.CONCLUSION: Even well differentiated or small dNEN harbour a considerable risk of metastases. These data challenge the concepts of surveillance, local resection and endoscopic management for dNEN based on size and grading. Angioinvasion was identified as a strong negative predictor of overall and disease-free survival in dNEN.

AB - BACKGROUND: Clinical management of duodenal neuroendocrine neoplasms (dNEN) is controversial. The aim of this study was to assess the outcome of surgical management and to identify risk factors for metastatic disease.METHODS: Patients undergoing surgery for dNEN were retrospectively analysed. Clinicopathologic features, perioperative outcome and survival were assessed. A literature review with focus on risk factors for metastatic disease was additionally performed.RESULTS: 24 patients were identified. Out of 22 patients presenting with their primary tumour, 20 patients underwent curative resection and 18 patients received curative resection with systematic lymphadenectomy. 17 patients underwent formal oncological resection. Surgical mortality was 1 out of 24 patients. The 5-year overall survival rate was 67% in the entire cohort, 71% in patients undergoing resection for their primary tumour, 72% for patients undergoing curative resection with systematic lymphadenectomy, 75% for pN0 and 70% for pN1 tumours. Lymph node metastases were identified in 15 patients undergoing systematic lymphadenectomy, including 9 of 14 patients with tumours smaller than 2 cm, and 6 of 10 patients with G1 tumours. Literature review confirmed a high risk of metastases in small (58%) or G1 (24%) tumours. Tumour grade and angioinvasion were significantly associated with overall and disease-free survival.CONCLUSION: Even well differentiated or small dNEN harbour a considerable risk of metastases. These data challenge the concepts of surveillance, local resection and endoscopic management for dNEN based on size and grading. Angioinvasion was identified as a strong negative predictor of overall and disease-free survival in dNEN.

KW - Aged

KW - Digestive System Surgical Procedures/methods

KW - Duodenal Neoplasms/pathology

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Metastasis

KW - Neoplasm Staging

KW - Neuroendocrine Tumors/diagnosis

KW - Retrospective Studies

KW - Risk Factors

U2 - 10.1016/j.ejso.2020.01.030

DO - 10.1016/j.ejso.2020.01.030

M3 - SCORING: Journal article

C2 - 32088004

VL - 46

SP - 1088

EP - 1096

JO - EJSO-EUR J SURG ONC

JF - EJSO-EUR J SURG ONC

SN - 0748-7983

IS - 6

ER -