Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Primavesi, F; Klieser, E; Cardini, B; Marsoner, K; Fröschl, U; Thalhammer, S; Fischer, I; Hauer, A; Urbas, R; Kiesslich, T; Neureiter, D; Zitt, M; Klug, R; Wundsam, H; Sellner, F; Karner, J; Függer, R; Cakar-Beck, F; Kornprat, P; Öfner, D; Stättner, S, , ASSO, pNEN, Study, Group.
Exploring the surgical landscape of pancreatic neuroendocrine neoplasia in Austria: Results from the ASSO pNEN study group.
Eur J Surg Oncol. 2019; 45(2):198-206
Doi: 10.1016/j.ejso.2018.08.016
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Kornprat Peter
- Marsoner Katharina
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- Abstract:
- INTRODUCTION: Pancreatic neuroendocrine neoplasia (pNEN) show increasing incidence and management is complex due to biological heterogeneity. Most publications report isolated high-volume single-centre data. This Austrian multi-centre study on surgical management of pNENs provides a comprehensive real-life picture of quality indicators, recurrence-patterns, survival factors and systemic treatments. METHODS: Retrospective, national cohort-study from 7 medium-/high-volume centres in Austria, coordinated under the auspices of the Austrian Society of Surgical Oncology (ASSO). RESULTS: Two-hundred patients underwent resection for pNEN, 177 had non-functioning tumours and 31 showed stage 4 disease. Participating centres were responsible for 2/3 of pNEN resections in Austria within the last years. The mean rate of completeness of variables was 98.6%. Ninety-days mortality was 3.5%, overall rate of complications was 42.5%. Morbidity did not influence long-term survival. The 5-year overall-survival (OS) was 81.3%, 10-year-OS 52.5% and 5-year recurrence-free-survival (RFS) 69.8%. Recurrence was most common in the liver (68.1%). Four out of five patients with recurrence underwent further treatment, most commonly with medical therapy or chemotherapy. Multivariable analysis revealed grading (HR:2.7) and metastasis (HR:2.5) as significant factors for relapse. Tumours-size ≥2 cm (HR:5.9), age ≥60 years (HR:3.1), metastasis (HR:2.3) and grading (HR:2.0) were associated with OS. Tumours <2 cm showed 93.9% 10-year-OS, but 33% had G2/G3 grading, 12.5% positive lymph-nodes and 4.7% metastasis at diagnosis, each associated with significant worse survival. CONCLUSION: Resection of pNENs in Austria is performed with internationally comparable safety. Analysed factors allow for risk-stratification in clinical treatment and future prospective trials. A watch-and-wait strategy purely based on tumour-size cannot be recommended.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Austria - epidemiology
- Female - administration & dosage
- Humans - administration & dosage
- Incidence - administration & dosage
- Lymphatic Metastasis - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Neoplasm Grading - administration & dosage
- Neoplasm Recurrence, Local - administration & dosage
- Neoplasm Staging - administration & dosage
- Neuroendocrine Tumors - epidemiology, pathology, surgery
- Pancreatectomy - administration & dosage
- Pancreatic Neoplasms - epidemiology, pathology, surgery
- Postoperative Complications - epidemiology
- Retrospective Studies - administration & dosage
- Survival Rate - administration & dosage
- Find related publications in this database (Keywords)
- Pancreatic nenroendocrine tumours
- Pancreatic neuroendocrine neoplasia
- Survival
- Pancreas
- Resection
- Surgery