切除和热消融治疗胰腺神经内分泌肿瘤肝转移的长期疗效。
Long-term outcome after resection and thermal hepatic ablation of pancreatic neuroendocrine tumour liver metastases.
机构信息
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
出版信息
BJS Open. 2021 Jul 6;5(4). doi: 10.1093/bjsopen/zrab062.
BACKGROUND
Pancreatic neuroendocrine tumours (Pan-NETs) are rare tumours that often present with or develop liver metastases. The aim of this retrospective study was to evaluate liver surgery and thermal hepatic ablation (THA) of Pan-NET liver metastases and to compare the outcomes with those of a control group.
METHOD
Patients with Pan-NET treated in Uppsala University Hospital and Sahlgrenska University Hospital from 1995-2018 were included. Patient records were scrutinized for baseline parameters, survival, treatment and complications.
RESULTS
Some 108 patients met the criteria for inclusion; 57 patients underwent treatment with liver surgery or THA and 51 constitute the control group. Median follow-up was 3.93 years. Five-year survival in the liver surgery/THA group was 70.6 (95 per cent c.i. 0.57 to 0.84) per cent versus 42.4 (95 per cent c.i. 40.7 to 59.1) per cent in the control group (P = 0.016) and median survival was 9.1 (95 per cent c.i. 6.5 to 11.7) versus 4.3 (95 per cent c.i. 3.4-5.2) years. In a multivariable analysis, surgery or THA was associated with a decreased death-years rate (hazard ratio 0.403 (95 per cent c.i. 0.208 to 0.782, P = 0.007).
CONCLUSION
Liver surgery and/or THA was associated with longer overall survival in Pan-NET with acceptable mortality and morbidity rates. These treatments should thus be considered in Pan-NET patients with reasonable tumour burden in an intent to alleviate symptoms and to improve survival.
背景
胰腺神经内分泌肿瘤（Pan-NETs）是罕见的肿瘤，常伴有或发展为肝转移。本回顾性研究旨在评估 Pan-NET 肝转移的肝切除术和热肝消融（THA），并与对照组的结果进行比较。
方法
纳入了 1995 年至 2018 年在乌普萨拉大学医院和萨尔格伦斯卡大学医院接受治疗的 Pan-NET 患者。检查了患者的基线参数、生存、治疗和并发症的病历记录。
结果
共有 108 例患者符合纳入标准；57 例患者接受了肝切除术或 THA 治疗，51 例为对照组。中位随访时间为 3.93 年。肝切除术/THA 组的 5 年生存率为 70.6%（95%可信区间 0.57 至 0.84），对照组为 42.4%（95%可信区间 40.7 至 59.1）（P=0.016），中位生存时间分别为 9.1 年（95%可信区间 6.5 至 11.7）和 4.3 年（95%可信区间 3.4-5.2）。多变量分析显示，手术或 THA 与降低死亡年率相关（风险比 0.403（95%可信区间 0.208 至 0.782，P=0.007））。
结论
对于 Pan-NET 患者，肝切除术和/或 THA 与总体生存率延长相关，死亡率和发病率可接受。因此，对于肿瘤负荷合理的 Pan-NET 患者，应考虑这些治疗方法，以减轻症状和提高生存率。
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