Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy.
Department of Haematology and Oncology (DIMES), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy.
Endocrine. 2019 Jun;64(3):702-707. doi: 10.1007/s12020-019-01870-8. Epub 2019 Feb 22.
The primary end-point was to evaluate the cure fraction. Secondary end-points were to investigate the time to cure, the excess of death risk, the probability of cure and the factors related to these parameters.
Retrospective study of an ENETS database regarding patients affected by Si-NENs. For each patients, clinical, pathological and follow-up data were collected. The survival analysis was made using a novel approach: the cure model approach.
The cure fraction was 92.1%. The death risk, time to cure and the probability of cure were 6/1000 person-years, 3.6 years and 98.2%, respectively. The independent factors influencing these parameters were the grading and the R status (P = 0.041 and P = 0.017, respectively). Patients affected by Si-NENs G2 increased the death risk and time to cure respect to Si-NENs G1 (51 versus 6 per 1000 person-years and 5.1 versus 3.6 years, respectively) as well as patients not operated respect to those radically resected (R0/1) (66 versus 1 per 1000 person-years and 4.8 versus 0.4 years, respectively). The probability of cure decreased (88.1 versus 97.8% and 80.4 versus 99.7%, respectively). R2 resection shows better results than no resection.
A large portion of patients affected by Si-NENs can be cured. The highest probability of cure regards patients with Si-NENs G1 who underwent to R0/R1 resection; the lower, those with Si-NENs G2 and no resection. R2 resection seems to be preferred respect to no resection.
主要终点是评估治愈率。次要终点是调查治愈时间、超额死亡风险、治愈概率以及与这些参数相关的因素。
对 ENETS 数据库中患有 Si-NENs 的患者进行回顾性研究。为每位患者收集临床、病理和随访数据。使用一种新的方法（治愈模型方法）进行生存分析。
治愈率为 92.1%。死亡风险、治愈时间和治愈概率分别为 6/1000 人年、3.6 年和 98.2%。影响这些参数的独立因素是分级和 R 状态（P=0.041 和 P=0.017）。G2 级 Si-NENs 患者的死亡风险和治愈时间均高于 G1 级患者（分别为 51 比 6 例/1000 人年和 5.1 比 3.6 年），未手术组患者的死亡风险和治愈时间也高于 R0/1 手术组（分别为 66 比 1 例/1000 人年和 4.8 比 0.4 年）。治愈概率降低（分别为 88.1%比 97.8%和 80.4%比 99.7%）。R2 切除比无切除效果更好。
很大一部分 Si-NENs 患者可以治愈。治愈概率最高的是 G1 级 Si-NENs 患者，他们接受了 R0/R1 切除术；治愈概率最低的是 G2 级和未接受手术的患者。与无切除相比，R2 切除似乎是更好的选择。
