Relapse factors for ileal neuroendocrine tumours after curative surgery: a retrospective French multicentre study

Dig Liver Dis. 2011 Oct;43(10):828-33. doi: 10.1016/j.dld.2011.04.021. Epub 2011 Jun 8.

Abstract

Aim: To evaluate the characteristics of postoperative relapse, predictive factors and time to relapse after curative surgery for well-differentiated neuroendocrine tumours of the ileum, without hepatic or other distant metastases.

Methods: Clinical data of patients entered into the Groupe d'étude des Tumeurs Endocrines database were collected and analysed retrospectively to identify factors predictive of relapse.

Results: Among 100 patients followed for a median of 56.5 (range 1-290) months, 42 relapsed after a median follow-up of 57.5 (range 6-176) months, with liver lesions in 27 (64.3%). Median disease-free survival (Kaplan-Meier) was 88 months (95% confidence interval 72-115). Disease-free survival was shorter for emergency surgery patients (p<0.01), patients with distant mesenteric lymph-node metastases (p<0.01), with fortuitous diagnosis (p=0.02), with tumour diameter >20mm (p=0.02), and those with multiple tumours (p=0.07). Multivariate analysis retained emergency surgery (odds-ratio 4.04 [95% confidence interval 2.01-8.11]), distant mesenteric lymph-node metastases (odds-ratio 2.53 [95% confidence interval 1.22-5.25]), and multiple tumours (odds-ratio 2.14 [95% confidence interval 1.01-4.50]), as being significantly associated with relapse.

Conclusion: Patients who underwent emergency surgery, with distant mesenteric lymph-node metastases or with multiple ileal tumours relapsed earlier. Closer monitoring for the patients with these risk factors may be required.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Emergencies
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Ileal Neoplasms / pathology*
  • Ileal Neoplasms / surgery
  • Kaplan-Meier Estimate
  • Liver Neoplasms / secondary*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Mesentery
  • Middle Aged
  • Multivariate Analysis
  • Neuroendocrine Tumors / pathology*
  • Neuroendocrine Tumors / secondary*
  • Neuroendocrine Tumors / surgery
  • Odds Ratio
  • Peritoneal Neoplasms / secondary*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tumor Burden*