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原发性胃肠胰神经内分泌肿瘤的可切除性作为生存的预后因素

Resectability of primary gastroenteropancreatic neuroendocrine tumor as a prognostic factor for survival.

作者信息

Medrano-Guzmán Rafael, López-García Sergio César, Torres-Vargas Sergio, González-Rodríguez Domingo, Alvarado-Cabrero Isabel

机构信息

Servicio de Sarcomas y Tubo Digestivo Alto, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, DF, Mexico.

出版信息

Cir Cir. 2011 Nov-Dec;79(6):498-504.

Abstract

BACKGROUND

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) originate from gastrointestinal cells and pancreas; most are benign or well-differentiated. GEP-NET treatment objectives are tumor resection and reduction of tumor growth and dissemination, as well as symptom amelioration. We undertook this study to identify prognostic factors among patients with GEP-NETs.

METHODS

A total of 48 patients with histopathological diagnosis of GEP-NET were examined. Dependent variables were disease-free survival (DFS) and overall survival rates. Independent variables were age, gender, primary tumor size, resectability, metastatic disease, and histological degree.

RESULTS

In 48 patients (60.4% female, 39.6% male, median age 54 years), overall survival rate was 43.7%, and DFS was 33 months. The most common location was gastric. Factors related with the poorest prognosis were histological degree types 2 and 3, tumors >2 cm, metastatic disease, and primary tumor irresectability. For DFS, the only adverse factor was histological degree.

CONCLUSIONS

Patients with recurrence of GEP-NET had a poorer prognosis. Complete resection of the lesion with negative margins is the most determining prognostic factor for overrall survival in patients with GEP-NET.

摘要

背景

胃肠胰神经内分泌肿瘤(GEP-NETs)起源于胃肠道细胞和胰腺;大多数为良性或高分化。GEP-NET的治疗目标是肿瘤切除、减少肿瘤生长和扩散以及缓解症状。我们开展这项研究以确定GEP-NET患者的预后因素。

方法

共检查了48例经组织病理学诊断为GEP-NET的患者。因变量为无病生存期(DFS)和总生存率。自变量为年龄、性别、原发肿瘤大小、可切除性、转移性疾病和组织学分级。

结果

48例患者(女性占60.4%,男性占39.6%,中位年龄54岁),总生存率为43.7%,DFS为33个月。最常见的部位是胃。与最差预后相关的因素是组织学分级2级和3级、肿瘤>2 cm、转移性疾病以及原发肿瘤不可切除。对于DFS,唯一的不良因素是组织学分级。

结论

GEP-NET复发患者预后较差。切缘阴性的病变完整切除是GEP-NET患者总生存的最关键预后因素。

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