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06.04.2018 | Hepatobiliary Tumors | Ausgabe 6/2018

Annals of Surgical Oncology 6/2018

Preoperative Fluorouracil, Doxorubicin, and Streptozocin for the Treatment of Pancreatic Neuroendocrine Liver Metastases

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 6/2018
Autoren:
MD Jordan M. Cloyd, MD Kiyohiko Omichi, MD Takashi Mizuno, MD Yoshikuni Kawaguchi, MD Ching-Wei D. Tzeng, MD Claudius Conrad, MD Yun Shin Chun, MD Thomas A. Aloia, MD Matthew H. G. Katz, MD Jeffrey E. Lee, MD Daniel Halperin, MD James Yao, MD Jean-Nicolas Vauthey, MD Arvind Dasari
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-018-6468-8) contains supplementary material, which is available to authorized users.
Jordan M. Cloyd and Kiyohiko Omichi have contributed equally to this work. Jean-Nicolas Vauthey and Arvind Dasari have contributed equally to this work.

Abstract

Introduction

While preoperative chemotherapy is frequently utilized before resection of non-neuroendocrine liver metastases, patients with resectable neuroendocrine liver metastases typically undergo surgery first. FAS is a cytotoxic chemotherapy regimen that is associated with substantial response rates in locally advanced and metastatic pancreatic neuroendocrine tumors.

Methods

All patients who underwent R0/R1 resection of pancreatic neuroendocrine liver metastases at a single institution between 1998 and 2015 were included. The outcomes of patients treated with preoperative FAS were compared with those of patients who were not.

Results

Of the 67 patients included, 27 (40.3%) received preoperative FAS, whereas 40 (59.7%) did not. Despite being associated with higher rates of synchronous disease, lymph node metastases, and larger tumor size, patients who received preoperative FAS had similar overall survival [overall survival (OS), 108.2 months (95% confidence interval (CI) 78.0–136.0) vs. 107.0 months (95% CI 78.0–136.0), p = 0.64] and recurrence-free survival [RFS, 25.1 months (95% CI 23.2–27.0) vs. 18.0 months (95% CI 13.8–22.2), p = 0.16] as patients who did not. Among patients who presented with synchronous liver metastases (n = 46), the median OS [97.3 months (95% CI 65.9–128.6) vs. 65.0 months (95% CI 28.1–101.9), p = 0.001] and RFS [24.8 months (95% CI 22.6–26.9) vs. 12.1 months (2.2–22.0), p = 0.003] were significantly greater among patients who received preoperative FAS compared with those who did not.

Conclusions

The use of FAS before liver resection is associated with improved OS compared with surgery alone among patients with advanced synchronous pancreatic neuroendocrine liver metastases.

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Zusatzmaterial
Supplementary material 1 (DOCX 13 kb)
10434_2018_6468_MOESM1_ESM.docx
Literatur
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