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Erschienen in: World Journal of Surgery 12/2021

11.08.2021 | Original Scientific Report

Survival Benefit of Primary Tumor Resection Among Elderly Patients with Pancreatic Neuroendocrine Tumors

verfasst von: Junya Toyoda, Kota Sahara, Diamantis I. Tsilimigras, Kentaro Miyake, Yasuhiro Yabushita, Yuki Homma, Takafumi Kumamoto, Ryusei Matsuyama, Timothy M. Pawlik

Erschienen in: World Journal of Surgery | Ausgabe 12/2021

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Abstract

Background

Pancreatectomy is the main curative therapeutic option for pancreatic neuroendocrine tumors (pNETs). Given the indolent behavior of pNETs and the relatively limited lifetime of elderly patients, the impact of primary site surgery (PSS) of pNETs on long-term outcomes among older patients has been a topic of debate.

Methods

Patients aged 70 or older with pNETs were identified in the Surveillance, Epidemiology and the End Results (SEER) database from 1998 to 2016. Propensity score matching was used to compare overall (OS) and cancer-specific survival (CSS) of patients who did versus did not undergo PSS.

Results

Among 2,319 elderly patients with pNETs, 942 patients (40.6%) underwent PSS, while 1,377 (59.4%) did not undergo PSS (non-PSS: NPSS). After propensity score matching (n = 433 in each group), PSS group had improved survival compared with the NPSS group (5-year OS: 53.4% vs. 37.3%; 5-year CSS: 77.2% vs. 58.1%, both p < 0.001). In contrast, subgroup analysis of individuals aged ≥ 80 revealed no difference in 5-year CSS (PSS: 69.2% vs. NPSS: 67.4%, p = 0.27). A subgroup analysis among patients who had small (≤ 2 cm) non-functional (NF) pNETs noted comparable long-term outcomes among patients who underwent PSS versus NPSS patients (5-year OS: 73.1% vs. 66.5%, p = 0.19; 5-year CSS: 98.5% vs. 95.2%, p = 0.14).

Conclusions

Approximately 2 in 5 elderly patients with pNETs underwent PSS. While PSS was generally associated with prolonged OS and CSS among older patients, PSS was not associated with improved CSS among a subset of patients aged 80 or older, as well as among patients age ≥ 70 years with NF-pNET less than 2 cm.
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Metadaten
Titel
Survival Benefit of Primary Tumor Resection Among Elderly Patients with Pancreatic Neuroendocrine Tumors
verfasst von
Junya Toyoda
Kota Sahara
Diamantis I. Tsilimigras
Kentaro Miyake
Yasuhiro Yabushita
Yuki Homma
Takafumi Kumamoto
Ryusei Matsuyama
Timothy M. Pawlik
Publikationsdatum
11.08.2021
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 12/2021
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-06281-3

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