Impact of surgical approach on short- and long-term outcomes in gastroenteropancreatic neuroendocrine carcinomas.

Abstract

Background

Literature is lacking on the impact of advancements in minimally invasive surgery (MIS) on outcomes for patients with gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs). Herein, we compared perioperative and oncologic outcomes among patients with GEP-NECs undergoing open, laparoscopic, and robotic resection.

Methods

Patients with GEP-NECs diagnosed 2010-2019 were identified from the National Cancer Database (NCDB). We used the inverse probability of treatment weighting method to account for selection bias. Patients were stratified by surgical approach; and pairwise comparisons were conducted by analyzing short- and long-term outcomes.

Results

Receipt of MIS increased from 34.2% in 2010 to 67.5 % in 2019. Altogether, 6560 patients met study criteria: 3444 (52.5%) underwent open resection, 2783 (42.4%) underwent laparoscopic resection and 333 (5.1%) underwent robotic resection. Compared with open resection, laparoscopic or robotic resection were associated with shorter post-operative length of stay, reduced 30-day and 90-day post-operative mortality, and prolonged overall survival (OS). Compared with laparoscopic resection, robotic resection was associated with reduced 90-day post-operative mortality, however, there was no significant difference in OS.

Conclusion

This NCDB analysis demonstrates that MIS approaches for treating GEP-NECs have become more common, with improved perioperative mortality, shorter post-operative length of stay and favorable OS, compared with open resection.

Department

Description

Provenance

Subjects

Citation

Published Version (Please cite this version)

10.1016/j.hpb.2023.06.008

Publication Info

Chen, Qichen, Kristen E Rhodin, Kan Li, Elishama Kanu, Sabino Zani, Michael E Lidsky, Jianjun Zhao, Qingyi Wei, et al. (2023). Impact of surgical approach on short- and long-term outcomes in gastroenteropancreatic neuroendocrine carcinomas. HPB : the official journal of the International Hepato Pancreato Biliary Association. p. S1365-182X(23)00557-9. 10.1016/j.hpb.2023.06.008 Retrieved from https://hdl.handle.net/10161/28570.

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Scholars@Duke

Rhodin

Kristen Rhodin

House Staff
Zani

Sabino Zani

Associate Professor of Surgery
Lidsky

Michael Evan Lidsky

Associate Professor of Surgery
Luo

Sheng Luo

Professor of Biostatistics & Bioinformatics

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