gms | German Medical Science

133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

Article

Send article

Palliative resection of the primary tumor in 442 metastasized neuroendocrine tumors of the pancreas: A population-based, propensity score-matched survival analysis

Meeting Abstract

Search Medline for

  • Felix J. Hüttner - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
  • Lutz Schneider - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
  • Ignazio Tarantino - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
  • Markus K. Diener - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
  • Markus Wolfgang Büchler - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
  • Alexis Ulrich - Universitätsklinikum Heidelberg, Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, 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. Doc16dgch564

doi: 10.3205/16dgch564, urn:nbn:de:0183-16dgch5648

Published: April 21, 2016

© 2016 Hüttner 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

Text

Background: There is an ongoing debate on whether palliative removal of the primary tumor may result in a survival benefit for patients with incurable stage IV pancreatic neuroendocrine tumors (P-NET). The objective of this study was to assess whether palliative resection of the primary tumor in patients with incurable stage IV P-NET has an impact on survival.

Materials and methods: Patients with stage IV P-NET registered in the Surveillance, Epidemiology and End Results database between 2004 and 2011 were identified. Those undergoing resection of metastases were excluded. Overall and cancer-specific survival of patients who did and did not undergo resection of their primary tumor were compared by means of risk-adjusted Cox proportional hazard regression analysis and propensity score-matched analysis.

Results: A total of 442 stage IV P-NET patients were identified, of whom 75 (17.0 %) underwent palliative primary tumor resection. The latter showed a significant benefit in both overall survival (hazard ratio [HR] of death = 0.41, 95% confidence interval [CI] 0.25–0.66, p < 0.001) and cancer-specific survival (HR of death = 0.41, 95% CI 0.25–0.67, p < 0.001) in unadjusted multivariate Cox regression analysis; the benefit persisted after propensity score adjustment.

Conclusion: This population-based analysis of stage IV P-NET patients provides compelling evidence that palliative resection of the primary tumor is associated with a significant survival benefit. Thus, the recent recommendations judging resection of the primary as inadvisable and the accompanying trend towards fewer palliative resections of the primary tumor have to be contested.