Department of Gastrointestinal Surgery, St Olav's Hospital - Trondheim University Hospital, Trondheim, Norway.
Department of Gastrointestinal Surgery, St Olav's Hospital - Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Surg Oncol. 2020 Dec;35:336-343. doi: 10.1016/j.suronc.2020.09.015. Epub 2020 Sep 18.
Small intestinal neuroendocrine tumors (SI-NETs) are slow growing but have frequently metastasized at the time of diagnosis. Most patients are operated with either curative intent or with intent to prolong overall survival. In the current study we have examined overall and disease-free survival in patients operated for SI-NETs.
All patients with a histological diagnosis of SI-NET at St Olav's hospital in the period 1998-2018 were reviewed retrospectively. Patient, disease and treatment characteristics including European Neuroendocrine Tumor Society (ENETS) TNM staging classification, surgery type, time to recurrence and survival were recorded.
A total of 186 patients were identified, whereof 54.3% male, median age at operation 68 years. The majority (n = 141 (75.8%)) underwent elective surgery and surgery was considered curative (radical) in 120 (64.5%) patients. Median estimated overall survival was 9.7 years (95% CI 7.6-11.8) for the entire population. Stage of disease, carcinoid heart disease, age, elective surgery, preoperatively known SI-NET, curative surgery and synchronous cancer were associated with survival in a multivariate analysis. Thirty-six of 120 (30%) patients had disease recurrence after a median follow-up time of 5.5 years, with a median estimated recurrence-free survival of 9.1 (5.4-12.9) years. Recurrence free survival was associated with age and synchronous cancer.
Patients with SI-NETs had long overall survival which seemed influenced by stage of disease, presence of carcinoid heart disease, an elective surgery, preoperatively known SI-NET, age and synchronous cancer. Appropriate preoperative diagnostic procedures and elective surgeries seem beneficial and should be aimed for.
小肠类癌（SI-NETs）生长缓慢，但在诊断时往往已发生转移。大多数患者接受手术治疗的目的或是为了根治，或是为了延长总体生存时间。在本研究中，我们检查了因 SI-NET 而接受手术的患者的总体生存和无病生存情况。
我们回顾性地审查了 1998 年至 2018 年期间在圣奥拉夫医院接受组织学诊断为 SI-NET 的所有患者。记录了患者、疾病和治疗特征，包括欧洲神经内分泌肿瘤学会（ENETS）TNM 分期分类、手术类型、复发时间和生存情况。
共确定了 186 例患者，其中男性占 54.3%，中位手术年龄为 68 岁。大多数患者（n=141（75.8%））接受了择期手术，120 例（64.5%）患者的手术被认为是根治性的。全人群的中位估计总体生存率为 9.7 年（95%CI7.6-11.8）。多变量分析显示，疾病分期、类癌性心脏病、年龄、择期手术、术前已知的 SI-NET、根治性手术和同时性癌症与生存相关。在中位随访时间为 5.5 年时，120 例患者中有 36 例（30%）出现疾病复发，中位无复发生存率为 9.1（5.4-12.9）年。无复发生存与年龄和同时性癌症有关。
SI-NET 患者的总体生存时间较长，这似乎受到疾病分期、类癌性心脏病、择期手术、术前已知的 SI-NET、年龄和同时性癌症的影响。适当的术前诊断程序和择期手术似乎是有益的，应该作为目标。
