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Presacral Neuroendocrine Neoplasms: A Multi-site Review of Surgical Outcomes
Tommaso Violante1,2, Brenda Murphy1, Davide Ferrari1,2,3
1Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
Annals of Surgical Oncology
|April 28, 2024
Summary
Presacral neuroendocrine neoplasms (PNENs) are rare, presenting challenges in management. This study highlights varied surgical approaches, common complications, and significant recurrence/metastasis rates, emphasizing the need for further research.
Area of Science:
- Oncology
- Surgical Pathology
- Neuroendocrinology
Background:
- Presacral neuroendocrine neoplasms (PNENs) are rare tumors with limited established management protocols and outcome data.
- Understanding PNENs is crucial due to their infrequent occurrence and complex clinical presentation.
Purpose of the Study:
- To analyze the clinical characteristics, management strategies, and outcomes of patients with presacral neuroendocrine neoplasms (PNENs).
- To provide insights into surgical approaches, complications, recurrence patterns, and survival rates for PNENs.
Main Methods:
- Retrospective review of medical records for patients diagnosed with PNENs between 2008 and 2022.
- Data collected included demographics, symptoms, imaging findings, surgical techniques, pathology, complications, and long-term follow-up.
- Kaplan-Meier analysis was used to assess recurrence and progression rates.
Main Results:
- Twelve PNEN patients (66.7% female, mean age 44.8 years) presented with pain, constipation, and abdominal discomfort; 50% had metastatic disease at diagnosis.
- Surgical approaches varied (anterior, posterior, combined), with complications in 25% of patients. Common pathological findings included well-differentiated grade 2 tumors.
- The 5-year rates were 23.8% for local recurrence, 14.3% for disease progression, and 30% for de novo metastases. No mortality was reported.
Conclusions:
- PNEN management is complex, requiring tailored surgical strategies and potentially adjuvant therapies.
- The study highlights significant rates of recurrence and metastasis, underscoring the need for multicenter research.
- Findings offer valuable insights for refining treatment strategies and improving outcomes for PNEN patients.
