肿瘤分级和原发部位可预测切除的胃肠胰神经内分泌肿瘤患者的复发和生存模式。

Tumour grade and primary site predict patterns of recurrence and survival in patients with resected gastroenteropancreatic neuroendocrine tumors.

机构信息

Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, V5Z 1M9, Canada.

出版信息

Am J Surg. 2021 Jun;221(6):1141-1149. doi: 10.1016/j.amjsurg.2021.03.027. Epub 2021 Mar 19.

DOI:10.1016/j.amjsurg.2021.03.027

PMID:33795127

Abstract

BACKGROUND

Patterns of recurrence help to inform surveillance of patients with resected gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

METHODS

Patients with GEP-NETs in British Columbia, Canada (2004-2015) were reviewed. Associations between tumor characteristics, recurrence and survival were analyzed.

RESULTS

Among 759 patients, 41%, 25%, and 17% had grade 1, 2, and 3 disease, respectively. 387 patients had R0/R1 resections, of which 30% recurred (median 25 months). 5-year incidence of recurrence was 22% (grade 1), 46% (grade 2), and 59% (grade 3) (p < 0.001). Grade predicted distant recurrence (Grade 2 HR 1.89, 95% CI 1.16-3.07; p = 0.011; Grade 3 HR 3.29, 95% CI 1.81-5.99; p < 0.001). Compared to small bowel NETs, pancreas NETs had less peritoneal recurrence (OR 0.15, 95% CI 0.03-0.68, p = 0.014). No patients had isolated pulmonary recurrences.

CONCLUSION

Higher grade tumors and pancreatic NETs require more frequent surveillance. Evidence is limited for pulmonary surveillance.

摘要

背景

肿瘤复发模式有助于为接受胃肠胰神经内分泌肿瘤（GEP-NETs）切除术的患者提供监测信息。

方法

对加拿大不列颠哥伦比亚省（2004-2015 年）的 GEP-NET 患者进行了回顾。分析了肿瘤特征、复发和生存之间的关联。

结果

在 759 名患者中，分别有 41%、25%和 17%的患者患有 1 级、2 级和 3 级疾病。387 名患者接受了 R0/R1 切除术，其中 30%的患者复发（中位复发时间为 25 个月）。5 年复发率为 22%（1 级）、46%（2 级）和 59%（3 级）（p<0.001）。分级预测远处复发（2 级 HR 1.89，95%CI 1.16-3.07；p=0.011；3 级 HR 3.29，95%CI 1.81-5.99；p<0.001）。与小肠 NET 相比，胰腺 NET 腹膜复发较少（OR 0.15，95%CI 0.03-0.68，p=0.014）。没有孤立性肺转移的患者。