PMID- 35963905
OWN - NLM
STAT- MEDLINE
DCOM- 20221013
LR  - 20221013
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 29
IP  - 12
DP  - 2022 Nov
TI  - Long-Term Outcomes for Patients with Multiple Endocrine Neoplasia Type 1 and 
      Duodenopancreatic Neuroendocrine Neoplasms.
PG  - 7808-7817
LID - 10.1245/s10434-022-12350-1 [doi]
AB  - BACKGROUND: Liver metastasis from duodenopancreatic neuroendocrine neoplasms 
      (DP-NENs) is a major cause of mortality in multiple endocrine neoplasia type 1 
      (MEN1) patients, yet much of their natural history is unknown. METHODS: This 
      longitudinal, retrospective cohort study analyzed all MEN1 patients with 
      imageable functional (F) and nonfunctional (NF) DP-NENs (1990-2021) for liver 
      metastasis-free survival (LMFS) and overall survival (OS). RESULTS: Of 138 
      patients, 85 (61.6%) had imageable DP-NENs (28 F, 57 NF), and the mean largest 
      tumor size was 1.8 +/- 1.4 cm. Multifocality was present in 32 patients (37.7%). 
      Surgery was performed for 49 patients (57.7%). During an 11-year median follow-up 
      period (IQR, 6-17 years), 23 (27.1%) of the patients had liver metastasis, and 19 
      (22.4%) patients died. Death was attributed to liver metastasis in 60% of cases. 
      The patients with F-DP-NENs versus NF-DP-NENs more often had liver metastasis 
      (46.4% vs. 15.8%; p = 0.002) but had similar 10-year LMFS (80.9 vs. 87.0%; p = 
      0.44) and OS (82.7 vs. 94.3%; p = 0.69). The patients with NF-DP-NENs had surgery 
      when their tumors were larger (p < 0.001). Tumor size was not associated with 
      liver metastasis (p = 0.89). The average growth rate was 0.04 cm/year (SE, 0.02 
      cm/year; p = 0.01) during active surveillance for NF-DP-NENs (n = 38). Liver 
      metastasis developed in four patients with tumors smaller than 2 cm. The risk of 
      liver metastasis was independent of surgery (hazard ratio [HR], 0.78; 95% 
      confidence interval [CI], 0.21-2.93; p = 0.72) and death (HR, 0.51; 95% CI, 
      0.08-3.06; p = 0.46). CONCLUSIONS: Although the observed outcomes in this study 
      were better than historical data, small NF-DP-NENs still developed liver 
      metastasis and liver metastasis remains a major cause of death. These results 
      suggest that size as a sole criterion for surgery may be insufficient to predict 
      tumor behavior.
CI  - (c) 2022. Society of Surgical Oncology.
FAU - Liu, Jason B
AU  - Liu JB
AD  - Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, 
      Pittsburgh, PA, USA.
AD  - Division of Gastrointestinal Surgical Oncology, Department of Surgery, University 
      of Pittsburgh, Pittsburgh, PA, USA.
FAU - Cai, Jinman
AU  - Cai J
AD  - Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
FAU - Dhir, Mashaal
AU  - Dhir M
AD  - Division of Hepatobiliary Surgery and Surgical Oncology, Department of Surgery, 
      Upstate University Hospital, Syracuse, NY, USA.
FAU - Paniccia, Alessandro
AU  - Paniccia A
AD  - Division of Gastrointestinal Surgical Oncology, Department of Surgery, University 
      of Pittsburgh, Pittsburgh, PA, USA.
FAU - Zureikat, Amer H
AU  - Zureikat AH
AD  - Division of Gastrointestinal Surgical Oncology, Department of Surgery, University 
      of Pittsburgh, Pittsburgh, PA, USA.
FAU - Ramonell, Kimberly M
AU  - Ramonell KM
AD  - Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, 
      Pittsburgh, PA, USA.
FAU - McCoy, Kelly L
AU  - McCoy KL
AD  - Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, 
      Pittsburgh, PA, USA.
FAU - Carty, Sally E
AU  - Carty SE
AD  - Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, 
      Pittsburgh, PA, USA.
FAU - Yip, Linwah
AU  - Yip L
AD  - Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, 
      Pittsburgh, PA, USA. yipl@upmc.edu.
LA  - eng
PT  - Journal Article
DEP - 20220813
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Humans
MH  - *Liver Neoplasms/secondary
MH  - *Multiple Endocrine Neoplasia Type 1/complications/surgery
MH  - *Neuroendocrine Tumors/pathology
MH  - *Pancreatic Neoplasms/pathology
MH  - Retrospective Studies
EDAT- 2022/08/14 06:00
MHDA- 2022/10/14 06:00
CRDT- 2022/08/13 23:19
PHST- 2022/06/09 00:00 [received]
PHST- 2022/07/21 00:00 [accepted]
PHST- 2022/08/14 06:00 [pubmed]
PHST- 2022/10/14 06:00 [medline]
PHST- 2022/08/13 23:19 [entrez]
AID - 10.1245/s10434-022-12350-1 [pii]
AID - 10.1245/s10434-022-12350-1 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2022 Nov;29(12):7808-7817. doi: 10.1245/s10434-022-12350-1. Epub 
      2022 Aug 13.