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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Prognostic factors influencing long-term survival in neuroendocrine neoplasms of the jejuno-ileum

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  • Anna Heverhagen - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Martha Maria Schuchmann - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Dominik Wiese - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Christian Meyer - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Jens Waldmann - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Detlef Klaus Bartsch - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland
  • Volker Fendrich - Universitätsklinikum Marburg, Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Marburg, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch488

doi: 10.3205/16dgch488, urn:nbn:de:0183-16dgch4889

Published: April 21, 2016

© 2016 Heverhagen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Neuroendocrine neoplasms (NEN) of the ileum are rare submucosal tumors that are often diagnosed at advanced stages with metastatic spread to the liver so that surgery is limited in most patients. Data on survival is scarce and not much is known about factors influencing survival.

Materials and methods: Data from all patients who underwent surgery for a neuroendocrine neoplasm of the ileum between 2000 and 2014 were retrieved from a prospective database. For each patient, gender, age at surgery of the primary, comorbidity, TNM-Classification, Ki67%, symptoms at diagnosis, status in somatostatin receptor scintigraphy, lymph node and liver metastasis, lymph node ratio, surgical procedure performed, localisation of the primary, blood group, rhesus factor, and preoperative CRP were recorded. Furthermore we recorded the time of follow up after the primary surgery for those patients who are still alive or the date of death.

Results: 125 patients were identified. After a median follow up of 48 months (range 1-157) 71 patients (56,8%) were still alive (Group I), 47 patients (37.6%) had already died (Group II) and 7 patients (5.6%) were lost to follow up. We could find statistically significant differences in survival depending on lymph node ratio. Patients still alive had a mean lymph node ratio of 0.158, whereas patients who died had a lymph node ratio of 0.488 (p=0.000). Between Group I and II there was a statistically significant difference concerning tumor localisation, surgical procedure, somatostatin receptor status and symptoms at diagnosis.

Conclusion: Localised and regionally restricted ileojejunal NEN have an excellent prognosis after surgical treatment. Lymph node ratio is a new detected prognostic factor in NEN of the jejuno-ileum and radical lymphadenectomy should be performed.