Management of Ileal Neuroendocrine Tumors with Liver Metastases

Andrea T. Fisher, Ashley L. Titan, Deshka S. Foster, Patrick J. Worth, George A. Poultsides, Brendan C. Visser, Monica M. Dua, Jeffrey A. Norton

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Assessment of treating metastatic ileal neuroendocrine tumors (NETs) with complete resection of primary tumor, nodal and liver metastases, plus administration of long-acting somatostatin analogues (SSAs). Methods: A prospective database was queried for patients with ileal or pancreatic NETs with pathology-confirmed liver metastases and tumor somatostatin receptors. Patients did not have MEN-1 and had no previous treatment. The impacts of SSA treatment on the primary outcome of survival and secondary outcome of progression-free survival were assessed with Kaplan–Meier analysis. Log rank test was used to compare overall and progression-free survival among groups. Results: Seventeen ileal NET patients and 36 pancreatic NET patients who underwent surgical resection between 2001 and 2018, who had pathology-confirmed liver metastases and confirmed tumor somatostatin receptors, did not have MEN-1, and had no previous treatment were identified. Median follow-up for patients with ileal NETs was 80 months (range 0–197 months) and 32 months (range 1–182 months) for pancreatic NETs. Five-year survival was 93% and 72% for ileal and pancreatic NET, respectively. Progression-free 5-year survival was 70% and 36% for ileal and pancreatic NET, respectively. Overall 5-year survival for pNETs was greater in those patients treated with SSA (79%) compared to those who underwent surgery alone (34%, p < 0.01). The average ECOG score was low for surviving patients with ileal (0.15) and pancreatic NET (0.73) indicating a good quality of life. Conclusions: Resection of primary lymph node and liver metastatic ileal or pancreatic NETs followed with continued SSAs is associated with an excellent progression-free and overall survival and minimal side effects.

Original languageEnglish (US)
Pages (from-to)1530-1539
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2020
Externally publishedYes

Keywords

  • Carcinoid
  • NET
  • Octreotide

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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