Department for General-, Visceral- and Minimalinvasive Surgery, Agaplesion Evangelisches Klinikum Schaumburg, Obernkirchen, Germany.
Department for Internal Medicine and Gastroenterology, Asklepios Hospital St. Georg, Lohmühlenstrasse 5, Hamburg, Germany.
Langenbecks Arch Surg. 2020 Mar;405(2):145-154. doi: 10.1007/s00423-020-01868-1. Epub 2020 May 5.
Neuroendocrine neoplasia (NEN) are rare and heterogenous tumours. Few data exist on the impact of surgical therapy.
This is a retrospective analysis of prospectively collected data of gastroenteropancreatic NEN in the German NET-Registry (1999-2012). It focuses on patients without distant metastases (limited disease, LD, stage I-IIIB).
Data of 2239 patients with NEN were recorded. Median age was 59 years, the gender ratio was 1:1.3 (f:m). A total of 986 patients (44%) had LD, and the 5-year survival rate (5 years) was 77% for all and 90% for patients with LD. A total of 1635 patients (73%) received a surgical therapy (1st to 6th line); the 5 and 10 ysr were 83/65% after and 59/35% without surgery for all patients (p < .001). The resection margins in the LD patients were 76%, 16%, and 3% for R0, R1 and R2, respectively. The 10 ysr was 84%, 59% and 42% for R0, R1 and R2 resections, respectively (p = .021 R0/R1, p < .001 R0/R2). The R0 resection rate was 75% for G1/G2 NET and 67% for G3 NEC.
The rate of complete tumour resection (R0) in LD is independent of tumour grading, and R0 resection is the key determinant of long-term survival, as demonstrated by the 10 ysr. of 84%. All NEN patients with limited disease should be considered for operation, if possible, as the best 10-year survival is shown after an R0 resection.
神经内分泌肿瘤（NEN）是罕见且异质性的肿瘤。关于手术治疗的影响，相关数据较少。
这是对德国神经内分泌肿瘤登记处（1999-2012 年）前瞻性收集的胃肠胰神经内分泌肿瘤数据的回顾性分析。它重点关注没有远处转移的患者（局限性疾病，LD，I-IIIB 期）。
记录了 2239 例 NEN 患者的数据。中位年龄为 59 岁，性别比例为 1:1.3（女：男）。共有 986 例（44%）患者为 LD，所有患者的 5 年生存率（5 年）为 77%，LD 患者为 90%。共有 1635 例（73%）患者接受了手术治疗（一线至六线）；所有患者手术后 5 和 10 年生存率分别为 83/65%和 59/35%（p<0.001）。LD 患者的切缘分别为 R0、R1 和 R2 的 76%、16%和 3%。R0、R1 和 R2 切除的 10 年生存率分别为 84%、59%和 42%（p=0.021 R0/R1，p<0.001 R0/R2）。G1/G2 NET 的 R0 切除率为 75%，G3 NEC 为 67%。
LD 中完全肿瘤切除（R0）的比例与肿瘤分级无关，R0 切除是长期生存的关键决定因素，10 年生存率为 84%。所有局限性疾病的 NEN 患者，如果可能的话，都应考虑手术，因为 R0 切除后的 10 年生存率最高。
