title: Relapse factors for ileal neuroendocrine tumours after curative surgery: a retrospective French multicentre study.
abstract: OBJECTIVE
  To evaluate the characteristics of postoperative relapse, predictive factors and time to relapse after curative surgery for well-differentiated neuroendocrine tumours of the ileum, without hepatic or other distant metastases.
  
  
  METHODS
  Clinical data of patients entered into the Groupe d'étude des Tumeurs Endocrines database were collected and analysed retrospectively to identify factors predictive of relapse.
  
  
  RESULTS
  Among 100 patients followed for a median of 56.5 (range 1-290) months, 42 relapsed after a median follow-up of 57.5 (range 6-176) months, with liver lesions in 27 (64.3%). Median disease-free survival (Kaplan-Meier) was 88 months (95% confidence interval 72-115). Disease-free survival was shorter for emergency surgery patients (p<0.01), patients with distant mesenteric lymph-node metastases (p<0.01), with fortuitous diagnosis (p=0.02), with tumour diameter >20mm (p=0.02), and those with multiple tumours (p=0.07). Multivariate analysis retained emergency surgery (odds-ratio 4.04 [95% confidence interval 2.01-8.11]), distant mesenteric lymph-node metastases (odds-ratio 2.53 [95% confidence interval 1.22-5.25]), and multiple tumours (odds-ratio 2.14 [95% confidence interval 1.01-4.50]), as being significantly associated with relapse.
  
  
  CONCLUSIONS
  Patients who underwent emergency surgery, with distant mesenteric lymph-node metastases or with multiple ileal tumours relapsed earlier. Closer monitoring for the patients with these risk factors may be required.
authors.affiliation: Service d'Hépato-Gastroentérologie et d'Oncologie Digestive, Hôpital Robert-Debré, CHU de Reims, Reims Cedex, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Le Roux
authors.forename: Catherine
authors.initials: C
authors.lastname: Lombard-Bohas
authors.forename: Christelle
authors.initials: C
authors.lastname: Delmas
authors.forename: Sophie
authors.initials: S
authors.lastname: Dominguez-Tinajero
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Samalin
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul
authors.forename: Pascal
authors.initials: P
authors.lastname: Renard
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Michel
authors.initials: M
authors.lastname: Robaskiewicz
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology* / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D015999:Multivariate Analysis; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D016017:Odds Ratio; D010534:Peritoneal Neoplasms / Q000556:secondary*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D047368:Tumor Burden