Survival effects of primary and metastatic surgical treatment in metastatic small intestinal tumors: A propensity score-matching study

TY - JOUR

T1 - Survival effects of primary and metastatic surgical treatment in metastatic small intestinal tumors: A propensity score-matching study

AU - Zhou, Zhongyi

AU - Ge, Heming

AU - Li, Yuqiang

AU - Wang, Dan

AU - Güngör, Cenap

PY - 2022

Y1 - 2022

N2 - OBJECTIVE: To analyze the effects of primary tumor resection and metastatic lesion resection on the survival of metastatic small intestinal tumors.METHODS: The research subjects were patients with metastatic small bowel tumors identified from 2004 to 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching and Kaplan-Meier analyses were performed to analyze the effect of surgery on the prognosis.RESULTS: A total of 4,034 patients from the SEER database were analyzed. Both before and after the propensity score-matching analysis, the prognosis of patients who underwent primary tumor surgery and metastatic surgery was better than that of patients who did not undergo surgery; all were patients with metastatic small bowel adenocarcinoma (mSIA) or metastatic small intestinal neuroendocrine tumors (mSI-NETs) (all p < .005). Patients with mSIA and adequate lymph node dissection had a longer prognosis than mSIA patients with inadequate lymph node dissection, but this survival benefit was not present in mSI-NET patients. It made no difference in the prognosis of mSIA and mSI-NETs whether localized surgery or intestine-ectomy was performed. Patients with mSIA who underwent primary and metastatic excision plus chemotherapy had the best overall survival and cancer-specific survival rates, whereas mSI-NET patients who underwent primary and metastatic excision had the best overall survival and cancer-specific survival rates (all p < .001).CONCLUSION: In these carefully selected patients, primary tumor resection and/or metastatic lesion resection significantly improved the survival rates for patients with mSIA and mSI-NETs. The mSIA patients with resectable primary tumors seemed to require a sufficient number of lymph node dissections more than the patients with well-differentiated mSI-NETs.

AB - OBJECTIVE: To analyze the effects of primary tumor resection and metastatic lesion resection on the survival of metastatic small intestinal tumors.METHODS: The research subjects were patients with metastatic small bowel tumors identified from 2004 to 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching and Kaplan-Meier analyses were performed to analyze the effect of surgery on the prognosis.RESULTS: A total of 4,034 patients from the SEER database were analyzed. Both before and after the propensity score-matching analysis, the prognosis of patients who underwent primary tumor surgery and metastatic surgery was better than that of patients who did not undergo surgery; all were patients with metastatic small bowel adenocarcinoma (mSIA) or metastatic small intestinal neuroendocrine tumors (mSI-NETs) (all p < .005). Patients with mSIA and adequate lymph node dissection had a longer prognosis than mSIA patients with inadequate lymph node dissection, but this survival benefit was not present in mSI-NET patients. It made no difference in the prognosis of mSIA and mSI-NETs whether localized surgery or intestine-ectomy was performed. Patients with mSIA who underwent primary and metastatic excision plus chemotherapy had the best overall survival and cancer-specific survival rates, whereas mSI-NET patients who underwent primary and metastatic excision had the best overall survival and cancer-specific survival rates (all p < .001).CONCLUSION: In these carefully selected patients, primary tumor resection and/or metastatic lesion resection significantly improved the survival rates for patients with mSIA and mSI-NETs. The mSIA patients with resectable primary tumors seemed to require a sufficient number of lymph node dissections more than the patients with well-differentiated mSI-NETs.

U2 - 10.1371/journal.pone.0270608

DO - 10.1371/journal.pone.0270608

M3 - SCORING: Journal article

C2 - 35749551

VL - 17

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 6

M1 - e0270608

ER -