Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France.
Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France.
World J Surg. 2020 Jul;44(7):2377-2384. doi: 10.1007/s00268-020-05467-5.
This study evaluated the short- and long-term outcomes of synchronous resection of liver metastases (LM) from small bowel neuroendocrine tumors (SB-NET).
A retrospective review of patients undergoing resection for LMs from SB-NETs from January 1997 and December 2018 was performed.
There were 44 patients with synchronous SB-NET and LMs. Perioperative and 90-day mortality values were zero, and the morbidity rate was 27%. The median overall survival (OS) was 128.4 months (CI 95% 74.0-161.5 months) with 1-, 3-, 5-, and 10-year survival rates of 100%, 83%, 79%, and 60%, respectively. Not achieving surgical treatment for LM was the unique independent factor for survival (HR 6.50; CI 95% 1.54-27.28; p = 0.01) in patients with unresected LMs having OS and 10-year survival rates (42 months, 33%) versus patients undergoing liver resection (152 months, 66%)(p = 0.0008). The recurrence rate was 81.8% and associated with longer OS and 5-year survival rates when limited to the liver [223 months (61%) vs 94 months (87%)].
Simultaneous resection of SB-NETs with synchronous LMs was safe and associated with considerable long-term survival even in the presence of bilobar disease. However, recurrence after resection was common (81%) but associated with longer survival rates when limited to the liver.
本研究评估了同时切除小肠类癌肝转移瘤（SB-NET）的短期和长期结果。
对 1997 年 1 月至 2018 年 12 月期间接受 SB-NET 肝转移瘤切除术的患者进行回顾性分析。
44 例患者同时存在 SB-NET 和 LM。围手术期和 90 天死亡率均为 0，发病率为 27%。中位总生存期（OS）为 128.4 个月（95%CI 74.0-161.5 个月），1、3、5 和 10 年生存率分别为 100%、83%、79%和 60%。未行 LM 手术切除是未切除 LM 患者生存的唯一独立因素（HR 6.50；95%CI 1.54-27.28；p=0.01），未切除 LM 患者的 OS 和 10 年生存率分别为 42 个月（33%）和接受肝切除术的患者（152 个月，66%）（p=0.0008）。复发率为 81.8%，当局限于肝脏时，与较长的 OS 和 5 年生存率相关[223 个月（61%）vs 94 个月（87%）]。
同时切除 SB-NET 合并同步 LM 是安全的，即使存在双侧疾病，也能获得相当长的生存时间。然而，切除后复发很常见（81%），但当局限于肝脏时，与较高的生存率相关。
