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Long-term Outcomes of Surgical Treatment for Pancreatic Neuroendocrine Neoplasm With Synchronous Hepatic Metastasis: A Multicenter Retrospective Cohort Study

  • 0From the Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences.
Pancreas +

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February 25, 2025

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February 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Resection of both primary pancreatic neuroendocrine neoplasms (pNEN) and synchronous hepatic metastases (sHMs) improved overall survival. However, this survival benefit was significant only for tumors in the pancreatic body/tail. Careful patient selection is crucial for surgical management.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Pancreatic neuroendocrine neoplasms (pNEN) with synchronous hepatic metastases (sHMs) present a complex management challenge.
  • The impact of surgical intervention on overall survival (OS) for these patients remains incompletely understood.

Purpose Of The Study

  • To evaluate the surgical impact on the overall survival (OS) of patients diagnosed with pancreatic neuroendocrine neoplasm (pNEN) and synchronous hepatic metastases (sHMs).

Main Methods

  • A cohort of 163 pNEN-sHM patients from three Chinese institutions were analyzed.
  • Patients were stratified into three groups: no resection, primary lesion resection, and combined primary and hepatic lesion resection (PHR).
  • Cox regression analysis was utilized to assess the effect of surgical intervention on OS.

Main Results

  • Overall cohort analysis indicated that PHR significantly improved OS (HR, 0.302; P = 0.007).
  • Subgroup analysis revealed a significant survival advantage for PHR in patients with pancreatic neuroendocrine tumors (pNET) located in the pancreatic body/tail (bt-pNET-sHM) (HR, 0.287; P = 0.040).
  • Surgical treatment did not yield a significant survival benefit for pancreatic neuroendocrine carcinoma-sHM or pancreatic head/neck pNET-sHM (hn-pNET-sHM).

Conclusions

  • The survival benefit of surgical intervention for pNEN-sHM was confined to the subgroup with tumors in the pancreatic body/tail.
  • Surgical management decisions for pNEN-sHM require careful, comprehensive assessment due to the multifactorial nature of the disease.
  • Avoidance of overly aggressive surgical strategies is recommended when benefits are not clearly demonstrated.