Timing of Disease Occurrence and Hepatic Resection on Long-Term Outcome of Patients with Neuroendocrine Liver Metastasis

• Autor(a) principal: Zhang, XF
• Data de Publicação: 2018
• Outros Autores: Beal, EW, Weiss, M, Aldrighetti, L, Poultsides, GA, Bauer, TW, Fields, RC, Maithel, SK, Pinto Marques, H, Pawlik, TM
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3485
• topic: Aged; Databases, Factual; Female; Follow-Up Studies; Hepatectomy; Humans; Incidence; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Neuroendocrine Tumors; Prognosis; Propensity Score; Time-to-Treatment; HCC CIR

Background and objectives: The objective of the study was to evaluate the impact of timing of disease occurrence and hepatic resection on long-term outcome of neuroendocrine liver metastasis (NELM). Methods: A total of 420 patients undergoing curative-intent resection for NELM were identified from a multi-institutional database. Date of primary resection, NELM detection and resection, intraoperative details, disease-specific (DSS), and recurrence-free survival (RFS) were obtained. Results: A total of 243 (57.9%) patients had synchronous NELM, while 177 (42.1%) developed metachronous NELM. On propensity score matching (PSM), patients with synchronous versus metachronous NELM had comparable DSS (10-year DSS, 76.2% vs 85.9%, P = 0.105), yet a worse RFS (10-year RFS, 34.1% vs 59.8%, P = 0.008). DSS and RFS were comparable regardless of operative approach (simultaneous vs staged, both P > 0.1). Among patients who developed metachronous NELM, no difference in long-term outcomes were identified between early (≤2 years, n = 102, 57.6%) and late (>2 years, n = 68, 42.4%) disease on PSM (both P > 0.1). Conclusions: Patients with synchronous NELM had a higher risk of tumor recurrence after hepatic resection versus patients with metachronous disease. The time to development of metachronous NELM did not affect long-term outcome. Curative-intent hepatic resection should be considered for patients who develop NELM regardless of the timing of disease presentation.