Timing of disease occurrence and hepatic resection on long-term outcome of patients with neuroendocrine liver metastasis

XF Zhang, EW Beal, M Weiss, L Aldrighetti, GA Poultsides, TW Bauer, RC Fields, SK Maithel, HP Marques, TM Pawlik

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Abstract

Background and Objectives: The objective of the study was to evaluate the impact of timing of disease occurrence and hepatic resection on long-term outcome of neuroendocrine liver metastasis (NELM). Methods: A total of 420 patients undergoing curative-intent resection for NELM were identified from a multi-institutional database. Date of primary resection, NELM detection and resection, intraoperative details, disease-specific (DSS), and recurrence-free survival (RFS) were obtained. Results: A total of 243 (57.9%) patients had synchronous NELM, while 177 (42.1%) developed metachronous NELM. On propensity score matching (PSM), patients with synchronous versus metachronous NELM had comparable DSS (10-year DSS, 76.2% vs 85.9%, P=0.105), yet a worse RFS (10-year RFS, 34.1% vs 59.8%, P=0.008). DSS and RFS were comparable regardless of operative approach (simultaneous vs staged, both P > 0.1). Among patients who developed metachronous NELM, no difference in long-term outcomes were identified between early (≤2 years, n=102, 57.6%) and late ( > 2 years, n=68, 42.4%) disease on PSM (both P > 0.1). Conclusions: Patients with synchronous NELM had a higher risk of tumor recurrence after hepatic resection versus patients with metachronous disease. The time to development of metachronous NELM did not affect long-term outcome. Curative-intent hepatic resection should be considered for patients who develop NELM regardless of the timing of disease presentation. © 2017 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)171-181
Number of pages11
JournalJournal of Surgical Oncology
Volume117
Issue number2
DOIs
Publication statusPublished - 2018

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Neoplasm Metastasis
Liver
Recurrence
Propensity Score
Survival
Databases

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Timing of disease occurrence and hepatic resection on long-term outcome of patients with neuroendocrine liver metastasis. / Zhang, XF; Beal, EW; Weiss, M; Aldrighetti, L; Poultsides, GA; Bauer, TW; Fields, RC; Maithel, SK; Marques, HP; Pawlik, TM.

In: Journal of Surgical Oncology, Vol. 117, No. 2, 2018, p. 171-181.

Research output: Contribution to journalArticle

Zhang, XF, Beal, EW, Weiss, M, Aldrighetti, L, Poultsides, GA, Bauer, TW, Fields, RC, Maithel, SK, Marques, HP & Pawlik, TM 2018, 'Timing of disease occurrence and hepatic resection on long-term outcome of patients with neuroendocrine liver metastasis', Journal of Surgical Oncology, vol. 117, no. 2, pp. 171-181. https://doi.org/10.1002/jso.24832
Zhang, XF ; Beal, EW ; Weiss, M ; Aldrighetti, L ; Poultsides, GA ; Bauer, TW ; Fields, RC ; Maithel, SK ; Marques, HP ; Pawlik, TM. / Timing of disease occurrence and hepatic resection on long-term outcome of patients with neuroendocrine liver metastasis. In: Journal of Surgical Oncology. 2018 ; Vol. 117, No. 2. pp. 171-181.
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abstract = "Background and Objectives: The objective of the study was to evaluate the impact of timing of disease occurrence and hepatic resection on long-term outcome of neuroendocrine liver metastasis (NELM). Methods: A total of 420 patients undergoing curative-intent resection for NELM were identified from a multi-institutional database. Date of primary resection, NELM detection and resection, intraoperative details, disease-specific (DSS), and recurrence-free survival (RFS) were obtained. Results: A total of 243 (57.9{\%}) patients had synchronous NELM, while 177 (42.1{\%}) developed metachronous NELM. On propensity score matching (PSM), patients with synchronous versus metachronous NELM had comparable DSS (10-year DSS, 76.2{\%} vs 85.9{\%}, P=0.105), yet a worse RFS (10-year RFS, 34.1{\%} vs 59.8{\%}, P=0.008). DSS and RFS were comparable regardless of operative approach (simultaneous vs staged, both P > 0.1). Among patients who developed metachronous NELM, no difference in long-term outcomes were identified between early (≤2 years, n=102, 57.6{\%}) and late ( > 2 years, n=68, 42.4{\%}) disease on PSM (both P > 0.1). Conclusions: Patients with synchronous NELM had a higher risk of tumor recurrence after hepatic resection versus patients with metachronous disease. The time to development of metachronous NELM did not affect long-term outcome. Curative-intent hepatic resection should be considered for patients who develop NELM regardless of the timing of disease presentation. {\circledC} 2017 Wiley Periodicals, Inc.",
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AU - Zhang, XF

AU - Beal, EW

AU - Weiss, M

AU - Aldrighetti, L

AU - Poultsides, GA

AU - Bauer, TW

AU - Fields, RC

AU - Maithel, SK

AU - Marques, HP

AU - Pawlik, TM

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N2 - Background and Objectives: The objective of the study was to evaluate the impact of timing of disease occurrence and hepatic resection on long-term outcome of neuroendocrine liver metastasis (NELM). Methods: A total of 420 patients undergoing curative-intent resection for NELM were identified from a multi-institutional database. Date of primary resection, NELM detection and resection, intraoperative details, disease-specific (DSS), and recurrence-free survival (RFS) were obtained. Results: A total of 243 (57.9%) patients had synchronous NELM, while 177 (42.1%) developed metachronous NELM. On propensity score matching (PSM), patients with synchronous versus metachronous NELM had comparable DSS (10-year DSS, 76.2% vs 85.9%, P=0.105), yet a worse RFS (10-year RFS, 34.1% vs 59.8%, P=0.008). DSS and RFS were comparable regardless of operative approach (simultaneous vs staged, both P > 0.1). Among patients who developed metachronous NELM, no difference in long-term outcomes were identified between early (≤2 years, n=102, 57.6%) and late ( > 2 years, n=68, 42.4%) disease on PSM (both P > 0.1). Conclusions: Patients with synchronous NELM had a higher risk of tumor recurrence after hepatic resection versus patients with metachronous disease. The time to development of metachronous NELM did not affect long-term outcome. Curative-intent hepatic resection should be considered for patients who develop NELM regardless of the timing of disease presentation. © 2017 Wiley Periodicals, Inc.

AB - Background and Objectives: The objective of the study was to evaluate the impact of timing of disease occurrence and hepatic resection on long-term outcome of neuroendocrine liver metastasis (NELM). Methods: A total of 420 patients undergoing curative-intent resection for NELM were identified from a multi-institutional database. Date of primary resection, NELM detection and resection, intraoperative details, disease-specific (DSS), and recurrence-free survival (RFS) were obtained. Results: A total of 243 (57.9%) patients had synchronous NELM, while 177 (42.1%) developed metachronous NELM. On propensity score matching (PSM), patients with synchronous versus metachronous NELM had comparable DSS (10-year DSS, 76.2% vs 85.9%, P=0.105), yet a worse RFS (10-year RFS, 34.1% vs 59.8%, P=0.008). DSS and RFS were comparable regardless of operative approach (simultaneous vs staged, both P > 0.1). Among patients who developed metachronous NELM, no difference in long-term outcomes were identified between early (≤2 years, n=102, 57.6%) and late ( > 2 years, n=68, 42.4%) disease on PSM (both P > 0.1). Conclusions: Patients with synchronous NELM had a higher risk of tumor recurrence after hepatic resection versus patients with metachronous disease. The time to development of metachronous NELM did not affect long-term outcome. Curative-intent hepatic resection should be considered for patients who develop NELM regardless of the timing of disease presentation. © 2017 Wiley Periodicals, Inc.

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