PMID- 25440487
OWN - NLM
STAT- MEDLINE
DCOM- 20150212
LR  - 20150202
IS  - 1879-1883 (Electronic)
IS  - 0002-9610 (Linking)
VI  - 208
IP  - 6
DP  - 2014 Dec
TI  - Metastasectomy of neuroendocrine tumors in patients with multiple endocrine 
      neoplasia type 1.
PG  - 1047-53; discussion 1052-3
LID - S0002-9610(14)00439-5 [pii]
LID - 10.1016/j.amjsurg.2014.08.010 [doi]
AB  - BACKGROUND: Neuroendocrine (NE) tumors commonly afflict patients with multiple 
      endocrine neoplasia type 1 (MEN1). It is thought that patients with MEN1 have 
      improved survival compared with individuals with analogous lesions. The role of 
      metastasectomy of NE tumors in MEN1 patients is not clearly defined. METHODS: A 
      review of MEN1 patients undergoing surgery for NE tumors from 1994 to 2010 at a 
      single tertiary care center was performed. Tumor function, the extent of 
      metastasis, R0 resection, and survival were analyzed. RESULTS: We identified 30 
      patients who underwent resection including synchronous and metachronous 
      metastasectomy. Synchronous metastases were identified in 19 patients (63%), 
      whereas 11 (37%) had metachronous disease. R0 resection was achieved in 93% of 
      patients. Estimated 10-year survival is 86.4% (95% confidence interval, 60% to 
      100%) with no factors predictive of overall survival. The disease-free interval 
      at 1, 5, and 10 years was 89%, 50%, and 19%, respectively, with recurrence 
      occurring at a median of 5.4 years (95% confidence interval, 77.7% to 100%). 
      Synchronous metastasis (P = .0072; hazard ratio [HR], 3.4) and nonfunctioning 
      tumors (P = .014; HR, 3.3) were more likely to recur, whereas age (P = .09; HR, 
      1.5), gender (P = .49; HR, 1.3), and the site of metastasis (P = .81; HR, 1.1) 
      did not influence recurrence. DISCUSSION: Patients with MEN1 benefit from 
      resection of metastatic NE disease. Despite a high recurrence rate, survival and 
      disease-free interval is favorable vs patients without MEN1.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Dy, Benzon M
AU  - Dy BM
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA.
FAU - Que, Florencia G
AU  - Que FG
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA.
FAU - Thompson, Geoffrey B
AU  - Thompson GB
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA.
FAU - Young, William F
AU  - Young WF
AD  - Department of Endocrinology, Mayo Clinic, 200 First Street SW, Rochester, MN 
      55905, USA.
FAU - Rowse, Phillip
AU  - Rowse P
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA.
FAU - Strajina, Veljko
AU  - Strajina V
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA.
FAU - Richards, Melanie L
AU  - Richards ML
AD  - Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, 
      USA. Electronic address: richards.melanie@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20140922
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
SB  - IM
MH  - Adult
MH  - Duodenal Neoplasms/*pathology/*surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - *Metastasectomy
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*pathology/*surgery
MH  - Neuroendocrine Tumors/*pathology/*surgery
MH  - Pancreatic Neoplasms/*pathology/*surgery
MH  - Survival Rate
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MEN 1
OT  - Metastasectomy
OT  - Neuroendocrine tumor
EDAT- 2014/12/03 06:00
MHDA- 2015/02/13 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/03/19 00:00 [received]
PHST- 2014/08/11 00:00 [revised]
PHST- 2014/08/13 00:00 [accepted]
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/02/13 06:00 [medline]
AID - S0002-9610(14)00439-5 [pii]
AID - 10.1016/j.amjsurg.2014.08.010 [doi]
PST - ppublish
SO  - Am J Surg. 2014 Dec;208(6):1047-53; discussion 1052-3. doi: 
      10.1016/j.amjsurg.2014.08.010. Epub 2014 Sep 22.