Values of debulking surgery for unresectable well-differentiated metastatic pancreatic neuroendocrine tumors: a comparative study. (8th March 2023)

• Record Type: Journal Article
• Authors: Huang, Xi-Tai; Xie, Jin-Zhao; Chen, Liu-Hua; Cai, Jian-Peng; Chen, Wei; Liang, Li-Jian; Zhang, Ning; Yin, Xiao-Yu
• Is Part Of: Gastroenterology report. Volume 11(2023)
• Publication Date: 2023-03-08
• Subjects: pancreatic neuroendocrine tumor -- metastasis -- debulking surgery -- prognosis; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1093/gastro/goad010
• Languages: English
• ISSNs: 2052-0034

Abstract

Abstract: Background and objective: The value of debulking surgery for unresectable well-differentiated metastatic pancreatic neuroendocrine tumor (m-PNET) remains poorly defined. This study aimed to evaluate the outcomes of m-PNET following debulking surgery in our institute. Methods: Patients with well-differentiated m-PNET in our hospital between February 2014 and March 2022 were collected. Clinicopathological and long-term outcomes of patients treated with radical resection, debulking surgery, and conservative therapy were compared retrospectively. Results: Fifty-three patients with well-differentiated m-PNET were reviewed, including 47 patients with unresectable m-PNET (debulking surgery, 25; conservative therapy, 22) and 6 patients with resectable m-PNET (radical resection). Patients undergoing debulking surgery had a post-operative Clavien–Dindo ≥ III complication rate of 16.0% without mortality. The 5-year overall survival (OS) rate of patients treated with debulking surgery was significantly higher than that of those treated with conservative therapy alone (87.5% vs 37.8%, log-rank P = 0.022). Besides, the 5-year OS rate of patients treated with debulking surgery was comparable to that of patients with resectable m-PNET undergoing radical resection (87.5% vs 100%, log-rank P = 0.724). Conclusions: Patients with unresectable well-differentiated m-PNET who underwent resection had better long-term outcomes than those who received conservative therapy alone. The 5-year OS of patients undergoing debulking surgery and radical resection were comparable. Debulking surgery could be considered for patients with unresectable well-differentiated m-PNET if no contraindication exists.