Butz Frederike, Dukaczewska Agata, Jann Henning, Dobrindt Eva Maria, Reinhard Lisa, Lurje Georg, Pratschke Johann, Goretzki Peter E, Schöning Wenzel, Mogl Martina T
Department of Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Department of Gastroenterology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Cancers (Basel). 2023 Mar 29;15(7):2048. doi: 10.3390/cancers15072048.
Indications for liver resection in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET) vary from liver resection with curative intent to tumor debulking or tissue sampling for histopathological characterization. With increasing expertise, the number of minimally invasive liver surgeries (MILS) in GEP-NET patients has increased. However, the influence on the oncological outcome has hardly been described. The clinicopathological data of patients who underwent liver resection for hepatic metastases of GEP-NET at the Department of Surgery, Charité-Universitätsmedizin Berlin, were analyzed. Propensity score matching (PSM) was performed to compare MILS with open liver surgery (OLS). In total, 22 patients underwent liver surgery with curative intent, and 30 debulking surgeries were analyzed. Disease-free survival (DFS) was longer than progression-free survival (PFS) (10 vs. 24 months), whereas overall survival (OS) did not differ significantly ( = 0.588). Thirty-nine (75%) liver resections were performed as OLS, and thirteen (25%) as MILS. After PSM, a shorter length of hospital stay was found for the MILS group (14 vs. 10 d, = 0.034), while neither DFS/PFS nor OS differed significantly. Both curative intended and cytoreductive resection of hepatic GEP-NET metastases achieved excellent outcomes. MILS led to a reduced length of hospital, while preserving a good oncological outcome.
胃肠胰神经内分泌肿瘤（GEP-NET）患者肝切除的适应证各不相同，从旨在治愈的肝切除到肿瘤减瘤或用于组织病理学特征分析的组织取样。随着专业技术的不断提高，GEP-NET患者的微创肝脏手术（MILS）数量有所增加。然而，其对肿瘤学结局的影响却鲜有描述。对柏林夏里特大学医学中心外科接受肝转移灶切除的GEP-NET患者的临床病理数据进行了分析。采用倾向评分匹配（PSM）法比较MILS与开放性肝脏手术（OLS）。共有22例患者接受了根治性肝手术，对30例减瘤手术进行了分析。无病生存期（DFS）长于无进展生存期（PFS）（10个月对24个月），而总生存期（OS）无显著差异（P = 0.588）。39例（75%）肝切除术为OLS，13例（25%）为MILS。PSM后，MILS组的住院时间较短（14天对10天，P = 0.034），而DFS/PFS和OS均无显著差异。GEP-NET肝转移灶的根治性切除和细胞减灭性切除均取得了良好的效果。MILS可缩短住院时间，同时保持良好的肿瘤学结局。
