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SHR Neuro Krebs Kardio Lipid

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
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Kornprat Peter
Marsoner Katharina
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Abstract:
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. Retrospective, national cohort-study from 7 medium-/high-volume centres in Austria, coordinated under the auspices of the Austrian Society of Surgical Oncology (ASSO). 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. 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. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Aged - epidemiology
Female -
Humans -
Incidence -
Lymphatic Metastasis -
Male -
Middle Aged -
Neoplasm Grading -
Neoplasm Recurrence, Local -
Neoplasm Staging -
Neuroendocrine Tumors - epidemiology
Neuroendocrine Tumors - pathology
Neuroendocrine Tumors - surgery
Pancreatectomy -
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Postoperative Complications - epidemiology
Retrospective Studies -
Survival Rate -

Find related publications in this database (Keywords)
Pancreatic nenroendocrine tumours
Pancreatic neuroendocrine neoplasia
Survival
Pancreas
Resection
Surgery
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