title: Surgical resection improves the outcome of the patients with neuroendocrine tumor liver metastases: large data from Asia.
abstract: How to properly manage neuroendocrine liver metastasis (NELM) remains debatable, and only limited clinical data have been published from Asian population. The objective of this study is to identify possible prognostic factors affecting overall survival time and to provide a guideline for future clinical practice. A retrospective study was performed on 1286 patients who had neuroendocrine tumors in our specialized center, and data from 130 patients who had NELM were summarized. Demographic and clinicopathologic data, tumor grade, treatment method, and prognosis were statistically analyzed. Most of the NELMs originated from pancreas (65.4%). Important prognostic factors that included tumor location and size were identified with multivariate analysis. Patients with either primary tumor resection or liver metastasis resection showed a 5-year survival of 35.7% or 33.3%, respectively, whereas resection of both resulted in a 50% 5-year survival. More importantly, resection was performed on 7 patients with grade 3 (G3) tumors, and resulted in 1-year, 3-year, and 5-year survival of 100%, 42.8%, and 28.6%, respectively, whereas the other 9 G3 patients without resection died within 3 years. P = 0.49 comparing the resected group with nonresected group in G3 patients. Besides, the overall 5-year survival rates for resected and nonresected patients were 40.5% and 5.4%, respectively. Multiple prognostic factors influenced the overall outcome of NELM including patient age, tumor location, and size, etc. Aggressive surgical approaches could be considered for maximum survival time disregarding the pathological grade of the tumor. Study with larger sample size should be considered to reevaluate the recommendation of the WHO guidelines for G3 neuroendocrine tumors.
authors.affiliation: From the Department of Liver Surgery (SD, ZW, XS, XL, YZ, HX, YX, TC, HZ, SZ, JH, YM); and Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and PUMC, 1# Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing, China (WW, QC).
authors.forename: Shunda
authors.initials: S
authors.lastname: Du
authors.forename: Zi
authors.initials: Z
authors.lastname: Wang
authors.forename: Xinting
authors.initials: X
authors.lastname: Sang
authors.forename: Xin
authors.initials: X
authors.lastname: Lu
authors.forename: Yongchang
authors.initials: Y
authors.lastname: Zheng
authors.forename: Haifeng
authors.initials: H
authors.lastname: Xu
authors.forename: Yiyao
authors.initials: Y
authors.lastname: Xu
authors.forename: Tianyi
authors.initials: T
authors.lastname: Chi
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhao
authors.forename: Wenze
authors.initials: W
authors.lastname: Wang
authors.forename: Quancai
authors.initials: Q
authors.lastname: Cui
authors.forename: Shouxian
authors.initials: S
authors.lastname: Zhong
authors.forename: Jiefu
authors.initials: J
authors.lastname: Huang
authors.forename: Yilei
authors.initials: Y
authors.lastname: Mao
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate