Impact of primary tumor resection and metastasectomy among gastroentero-pancreatic neuroendocrine tumors with liver metastases only on survival.

dc.contributor.author

Chen, Qichen

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Li, Kan

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Rhodin, Kristen E

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Bartholomew, Alex J

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Lidsky, Michael E

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Wei, Qingyi

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Cai, Jianqiang

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Luo, Sheng

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Zhao, Hong

dc.date.accessioned

2023-11-01T13:29:50Z

dc.date.available

2023-11-01T13:29:50Z

dc.date.issued

2023-09

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2023-11-01T13:29:49Z

dc.description.abstract

Background

Despite recommendations for primary tumor resection (PTR) with or without liver resection (LR) in the patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and isolated liver metastases, there are conflicting data for their impact on overall survival (OS).

Methods

2320 patients with GEP-NETs and isolated liver metastases were identified from NCDB. Multiple imputations were used to accommodate missing data, and inverse probability of treatment weighting (IPTW) was conducted to minimize bias.

Results

Patients with PTR had a greater OS than those without PTR (3-year rate of 88.6% vs. 69.9%, P < 0.001), which was preserved in the adjusted analysis (IPTW-adjusted HR = 0.387, 95% CI: 0.264-0.567; P < 0.001). Patients with LR had a greater OS than those without LR (3-year rate 87.7% vs. 75.2%, P = 0.003), which was also preserved in adjusted analysis (IPTW-adjusted HR = 0.450, 95% CI: 0.229-0.885; P = 0.021). Patients undergoing both PTR and LR had the greatest survival advantage than those with other surgical interventions (P < 0.001).

Conclusions

Either PTR or LR is associated with improved survival for GEP-NET patients with isolated liver metastases. However, there remains significant selection bias in the current study, and caution should be exercised when selecting patients for resection.
dc.identifier

S1365-182X(23)01941-X

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1365-182X

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1477-2574

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https://hdl.handle.net/10161/29315

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eng

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Elsevier BV

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HPB : the official journal of the International Hepato Pancreato Biliary Association

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10.1016/j.hpb.2023.09.016

dc.title

Impact of primary tumor resection and metastasectomy among gastroentero-pancreatic neuroendocrine tumors with liver metastases only on survival.

dc.type

Journal article

duke.contributor.orcid

Wei, Qingyi|0000-0002-3845-9445|0000-0003-4115-4439

duke.contributor.orcid

Luo, Sheng|0000-0003-4214-5809

pubs.begin-page

S1365-182X(23)01941-X

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Biostatistics & Bioinformatics

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Medicine

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Surgery

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Medicine, Medical Oncology

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Global Health Institute

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Population Health Sciences

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Surgical Oncology

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Biostatistics & Bioinformatics, Division of Biostatistics

pubs.publication-status

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