Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

R B Galleberg; U Knigge; E Tiensuu Janson; L W Vestermark; Sven-Petter Haugvik; M Ladekarl; S W Langer; H Grønbæk; Pia Österlund; G O Hjortland; J Assmus; L Tang; A. Perren; H Sorbye

doi:10.1016/j.ejso.2017.04.010

Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

R B Galleberg, U Knigge, E Tiensuu Janson, L W Vestermark, Sven-Petter Haugvik, M Ladekarl, S W Langer, H Grønbæk, Pia Österlund, G O Hjortland, J Assmus, L Tang, A. Perren, H Sorbye

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

42 Citations (Scopus)

Abstract

BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC.

METHODS: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups.

RESULTS: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA.

CONCLUSION: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

Original language	English
Journal	European Journal of Surgical Oncology
Volume	43
Issue number	9
Pages (from-to)	1682-1689
Number of pages	8
ISSN	0748-7983
DOIs	https://doi.org/10.1016/j.ejso.2017.04.010
Publication status	Published - Sept 2017
Externally published	Yes

Access to Document

10.1016/j.ejso.2017.04.010

AUB Link

Search for the material in Aalborg University Library's search engine

Cite this

Galleberg, R. B., Knigge, U., Tiensuu Janson, E., Vestermark, L. W., Haugvik, S-P., Ladekarl, M., Langer, S. W., Grønbæk, H., Österlund, P., Hjortland, G. O., Assmus, J., Tang, L., Perren, A., & Sorbye, H. (2017). Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas. European Journal of Surgical Oncology, 43(9), 1682-1689. Advance online publication. https://doi.org/10.1016/j.ejso.2017.04.010

@article{b2f7a7aa884a4aa1803035d5929d297f,

title = "Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas",

abstract = "BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC.METHODS: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups.RESULTS: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA.CONCLUSION: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.",

author = "Galleberg, {R B} and U Knigge and {Tiensuu Janson}, E and Vestermark, {L W} and Sven-Petter Haugvik and M Ladekarl and Langer, {S W} and H Gr{\o}nb{\ae}k and Pia {\"O}sterlund and Hjortland, {G O} and J Assmus and L Tang and A. Perren and H Sorbye",

year = "2017",

month = sep,

doi = "10.1016/j.ejso.2017.04.010",

language = "English",

volume = "43",

pages = "1682--1689",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

publisher = "Elsevier",

number = "9",

}

Galleberg, RB, Knigge, U, Tiensuu Janson, E, Vestermark, LW, Haugvik, S-P, Ladekarl, M, Langer, SW, Grønbæk, H, Österlund, P, Hjortland, GO, Assmus, J, Tang, L, Perren, A & Sorbye, H 2017, 'Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas', European Journal of Surgical Oncology, vol. 43, no. 9, pp. 1682-1689. https://doi.org/10.1016/j.ejso.2017.04.010

TY - JOUR

T1 - Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

AU - Galleberg, R B

AU - Knigge, U

AU - Tiensuu Janson, E

AU - Vestermark, L W

AU - Haugvik, Sven-Petter

AU - Ladekarl, M

AU - Langer, S W

AU - Grønbæk, H

AU - Österlund, Pia

AU - Hjortland, G O

AU - Assmus, J

AU - Tang, L

AU - Perren, A.

AU - Sorbye, H

PY - 2017/9

Y1 - 2017/9

N2 - BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC.METHODS: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups.RESULTS: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA.CONCLUSION: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

AB - BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC.METHODS: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups.RESULTS: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA.CONCLUSION: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

U2 - 10.1016/j.ejso.2017.04.010

DO - 10.1016/j.ejso.2017.04.010

M3 - Journal article

C2 - 28522174

SN - 0748-7983

VL - 43

SP - 1682

EP - 1689

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 9

ER -

Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

Abstract

Access to Document

AUB Link

Fingerprint

Cite this