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Contemporary indications for and outcomes of hepatic resection for neuroendocrine liver metastases
Contemporary indications for and outcomes of hepatic resection for neuroendocrine liver metastases
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BACKGROUND Although surgical resection is associated with the best long-term outcomes for neuroendocrine liver metastases(NELM),the current indications for and outcomes of surgery for NELM from a population perspective are not well understood.AIM To determine the current indications for and outcomes of liver resection(LR)for NELM using a population-based cohort.METHODS A retrospective review of the 2014-2017 American College of Surgeons National Surgical Quality Improvement Program and targeted hepatectomy databases was performed to identify patients who underwent LR for NELM.Perioperative characteristics and 30-d morbidity and mortality were analyzed.RESULTS Among 669 patients who underwent LR for NELM,the median age was 60(interquartile range:51-67)and 51%were male.While the number of metastases resected ranged from 1 to 9,the most common(45%)number of tumors resected was one.The majority(68%)of patients had a largest tumor size of<5 cm.Most patients underwent partial hepatectomy(71%)while fewer underwent a right or left hepatectomy or trisectionectomy.The majority of operations were open(82%)versus laparoscopic(17%)or robotic(1%).In addition,30%of patients underwent intraoperative ablation while 45%had another concomitant operation including cholecystectomy(28.8%),bowel resection(20.2%),or partial pancreatectomy(3.4%).Overall 30-d morbidity and mortality was 29%and 1.3%,respectively.On multivariate analysis,American Society of Anesthesiologists class≥3[odds ratios(OR),OR=2.089,95%confidence intervals(CI):1.197-3.645],open approach(OR=1.867,95%CI:1.148-3.036),right hepatectomy(OR=1.618,95%CI:1.014-2.582),and prolonged operative time of>230 min(OR=1.731,95%CI:1.168-2.565)were associated with higher 30-d morbidity while intraoperative ablation and concomitant procedures were not.CONCLUSION LR for NELM was performed with relatively low postoperative morbidity and mortality.Concomitant procedures performed at the time of LR did not increase morbidity.
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| 篇名 | Contemporary indications for and outcomes of hepatic resection for neuroendocrine liver metastases | ||
| 来源期刊 | 世界胃肠外科杂志:英文版(电子版) | 学科 | 医学 |
| 关键词 | CARCINOID NEUROENDOCRINE TUMOR Primary TUMOR RESECTION INTRAOPERATIVE ablation CHOLECYSTECTOMY Small bowel RESECTION | ||
| 年，卷（期） | 2020,（4） | 所属期刊栏目 | |
| 研究方向 | 页码范围 | 159-170 | |
| 页数 | 12页 | 分类号 | R735.7 |
| 字数 | 语种 | ||
| DOI | |||
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CARCINOID
NEUROENDOCRINE
TUMOR
Primary
TUMOR
RESECTION
INTRAOPERATIVE
ablation
CHOLECYSTECTOMY
Small
bowel
RESECTION
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世界胃肠外科杂志：英文版（电子版）
主办单位：
百世登出版集团有限公司
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月刊
ISSN：
1948-9366
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出版地：
北京市朝阳区东四环中路62号楼远洋国际中
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75
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0
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