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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Merola, E; Rinke, A; Partelli, S; Gress, TM; Andreasi, V; Kollár, A; Perren, A; Christ, E; Panzuto, F; Pascher, A; Jann, H; Arsenic, R; Cremer, B; Kaemmerer, D; Kump, P; Lipp, RW; Agaimy, A; Wiedenmann, B; Falconi, M; Pavel, ME.
Surgery with Radical Intent: Is There an Indication for G3 Neuroendocrine Neoplasms?
Ann Surg Oncol. 2020; 27(5):1348-1355 Doi: 10.1245/s10434-019-08049-5
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Co-Autor*innen der Med Uni Graz
Kump Patrizia
Lipp Rainer

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BACKGROUND: While platinum-based chemotherapy represents the standard treatment for advanced grade 3 (G3) neuroendocrine neoplasms (NENs) according to the European Neuroendocrine Tumor Society guidelines, the role of radical-intended surgery in these patients, as well as the use of adjuvant chemotherapy, are still controversial. The aim of the present work is to describe, in a retrospective series of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) G3, the overall survival (OS) rate and risk factors for death after radical surgery. Secondary aims are the description of median recurrence-free survival (RFS) and of the role of adjuvant chemotherapy. PATIENTS AND METHODS: Multicenter analysis of a series of stage I-III GEP-NEN G3 patients receiving radical surgery (R0/R1) with/without adjuvant chemotherapy was performed. RESULTS: Sixty patients from eight neuroendocrine tumor (NET) referral centers, with median follow-up of 23 months (5-187 months) were evaluated. While 28.6% of cases had NET G3, 71.4% had neuroendocrine carcinoma G3 (NEC G3). The 2-year OS rate after radical surgery was 64.5%, with a statistically significant difference in terms of Ki67 threshold (cut-off 55%, P = 0.03) and tumor differentiation (NEC G3 vs. NET G3, P = 0.03). Median RFS after radical surgery was 14 months, and 2-year RFS rate was 44.9%. Use of adjuvant chemotherapy provided no benefit in terms of either OS or RFS in this series. CONCLUSIONS: Surgery with radical intent might represent a valid option for GEP-NEN G3 patients with locoregional disease, especially with Ki67 value ≤ 55%.
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Carcinoma, Neuroendocrine - pathology, surgery
Chemotherapy, Adjuvant - administration & dosage
Colectomy - administration & dosage
Colorectal Neoplasms - pathology, surgery
Digestive System Surgical Procedures - methods
Disease-Free Survival - administration & dosage
Esophagectomy - administration & dosage
Female - administration & dosage
Gastrectomy - administration & dosage
Gastrointestinal Neoplasms - pathology, surgery
Humans - administration & dosage
Ki-67 Antigen - administration & dosage
Male - administration & dosage
Margins of Excision - administration & dosage
Middle Aged - administration & dosage
Neoplasm Grading - administration & dosage
Neoplasm Recurrence, Local - epidemiology
Neoplasm Staging - administration & dosage
Neuroendocrine Tumors - pathology, surgery
Pancreatectomy - administration & dosage
Pancreatic Neoplasms - pathology, surgery
Pancreaticoduodenectomy - administration & dosage
Platinum Compounds - therapeutic use
Proctectomy - administration & dosage
Retrospective Studies - administration & dosage
Survival Rate - administration & dosage

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