Primary Resection and Metastasectomy for Well-Differentiated Grade 3 Gastro-Entero-Pancreatic Neuroendocrine Tumors: A National Cancer Database Analysis

Vollständiger Abstract

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Abstract Background In patients with synchronous liver-metastatic low-grade (WHO grade 1/2) gastro-entero-pancreatic neuroendocrine tumors (GEPNETs), resection of primary and liver metastases is associated with improved overall survival (OS). The benefit of surgical resection in metastatic well-differentiated grade 3 GEPNETs, a recently defined tumor grade, remains unclear. We aimed to define survival benefit from primary resection and liver metastasectomy in patients with well-differentiated WHO grade (G) 3 GEPNETs. Methods Patients diagnosed with well-differentiated WHO grade 1—3 synchronous liver-metastatic GEPNETs between 2018–2021 were identified from the National Cancer Database (NCDB). Kaplan-Meier and multivariable Cox proportional hazards modeling were utilized to evaluate the association of primary tumor and liver resection with OS. Results Among 3,198 patients (G1: n =1434; G2: n =1113; G3: n =651), surgical intervention decreased with higher grade (G1: 67.3%; G2: 62.4%; G3: 31.3%, P