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Neuroendocrine liver metastasis: The chance to be cured after liver surgery
Author(s) -
Bagante Fabio,
Spolverato Gaya,
Merath Katiuscha,
Postlewait Lauren McLendon,
Poultsides George A.,
Mullen Matthew G.,
Bauer Todd W.,
Fields Ryan C.,
Lamelas Jorge,
Marques Hugo P.,
Aldrighetti Luca,
Tran Thuy,
Maithel Shishir K.,
Pawlik Timothy M.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24563
Subject(s) - medicine , metastasis , surgery , hepatectomy , neuroendocrine tumors , resection , gastroenterology , cancer
Background and Objective Neuroendocrine liver metastasis tumors (NELM) are a heterogeneous group of neoplasms with varied histologic features and a wide range of clinical behaviors. We aimed to identify the fraction of patients cured after liver surgery for NELM. Methods Cure fraction models were used to analyze 376 patients who underwent hepatectomy with curative intent for NELM. Results The median and 5‐year disease‐free survival (DFS) were 4.5 years and 46%, respectively. The probability of being cured from NELM by liver surgery was 44%; the time to cure was 5.1 years. In a multivariable cure model, type of neuroendocrine tumor (NET), grade of tumor differentiation, and rate of liver involvement resulted as independent predictors of cure. The cure fraction for patients with well differentiated NELM from gastrointestinal NET or a functional pancreatic NET, and with <50% of liver‐involvement was 95%. Patients who had moderately/poorly differentiated NELM from a non‐functional pancreatic NET, and with <50% of liver‐involvement was 43%. In the presence of all the three unfavorable prognostic factors (nonfunctional PNET, liver involvement >50%, moderately/poorly differentiation), the cure fraction was 8%. Conclusions Statistical cure after surgery for NELM is possible, and allow for a more accurate prediction of long‐term outcome among patients with NELM undergoing liver resection.