Surgery with Radical Intent: Is There an Indication for G3 Neuroendocrine Neoplasms?

Merola E, Rinke A, Partelli S, Gress TM, Andreasi V, Kollar A, Perren A, Christ E, Panzuto F, Pascher A, Jann H, Arsenic R, Cremer B, Kaemmerer D, Kump P, Lipp RW, Agaimy A, Wiedenmann B, Falconi M, Pavel ME (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Annals of Surgical Oncology Springer Verlag (Germany)

DOI: 10.1245/s10434-019-08049-5

Abstract

Background: While platinum-based chemotherapy represents the standard treatment for advanced grade 3 (G3) neuroendocrine neoplasms (NENs) according to the European Neuroendocrine Tumor Society guidelines, the role of radical-intended surgery in these patients, as well as the use of adjuvant chemotherapy, are still controversial. The aim of the present work is to describe, in a retrospective series of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) G3, the overall survival (OS) rate and risk factors for death after radical surgery. Secondary aims are the description of median recurrence-free survival (RFS) and of the role of adjuvant chemotherapy. Patients and Methods: Multicenter analysis of a series of stage I–III GEP-NEN G3 patients receiving radical surgery (R0/R1) with/without adjuvant chemotherapy was performed. Results: Sixty patients from eight neuroendocrine tumor (NET) referral centers, with median follow-up of 23 months (5–187 months) were evaluated. While 28.6% of cases had NET G3, 71.4% had neuroendocrine carcinoma G3 (NEC G3). The 2-year OS rate after radical surgery was 64.5%, with a statistically significant difference in terms of Ki67 threshold (cut-off 55%, P = 0.03) and tumor differentiation (NEC G3 vs. NET G3, P = 0.03). Median RFS after radical surgery was 14 months, and 2-year RFS rate was 44.9%. Use of adjuvant chemotherapy provided no benefit in terms of either OS or RFS in this series. Conclusions: Surgery with radical intent might represent a valid option for GEP-NEN G3 patients with locoregional disease, especially with Ki67 value ≤ 55%.

Authors with CRIS profile

Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Marianne Ellen Pavel Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Medizinische Universität Graz AT Austria (AT) Universitätsklinikum Köln DE Germany (DE) Università Vita-Salute San Raffaele (UniSR) IT Italy (IT) Charité - Universitätsmedizin Berlin DE Germany (DE) Zentralklinikum Bad Berka DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Universitätsspital Basel CH Switzerland (CH) Universität Bern CH Switzerland (CH) Universitätsklinikum Münster DE Germany (DE)

How to cite

APA:

Merola, E., Rinke, A., Partelli, S., Gress, T.M., Andreasi, V., Kollar, A.,... Pavel, M.E. (2019). Surgery with Radical Intent: Is There an Indication for G3 Neuroendocrine Neoplasms? Annals of Surgical Oncology. https://doi.org/10.1245/s10434-019-08049-5

MLA:

Merola, Elettra, et al. "Surgery with Radical Intent: Is There an Indication for G3 Neuroendocrine Neoplasms?" Annals of Surgical Oncology (2019).

BibTeX: Download