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Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias

Albers, Max B. ; Almquist, Martin LU ; Bergenfelz, Anders LU and Nordenström, Erik LU (2020) In Langenbeck's Archives of Surgery 405(2). p.137-143
Abstract
Purpose: Surgery is recommended for most patients with gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NENs). Rates of complications and perioperative mortality have been reported in few mostly retrospective single-center series, but there has been no detailed analysis on risk factors for perioperative complications and mortality to date. Methods: Data of patients with GEP-NENs operated between January 2015 and September 2018 were retrieved from EUROCRINE©, a European online endocrine surgical quality registry, and analyzed regarding rate and risk factors of surgical complications. Risk factors were assessed by logistic regression. Results: Some 376 patients (211 female, 167 male; age median 63, range 15–89 years) were included.... (More)
Purpose: Surgery is recommended for most patients with gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NENs). Rates of complications and perioperative mortality have been reported in few mostly retrospective single-center series, but there has been no detailed analysis on risk factors for perioperative complications and mortality to date. Methods: Data of patients with GEP-NENs operated between January 2015 and September 2018 were retrieved from EUROCRINE©, a European online endocrine surgical quality registry, and analyzed regarding rate and risk factors of surgical complications. Risk factors were assessed by logistic regression. Results: Some 376 patients (211 female, 167 male; age median 63, range 15–89 years) were included. Most NENs were located in the small intestine (SI) (n = 132) or pancreas (n = 111), the rest in the stomach (n = 34), duodenum (n = 30), appendix (n = 30), colon, and rectum (n = 22), or with unknown primary (n = 15). Of the tumors, 320 (85.1%) were well or moderately differentiated, and 147 (39.1%) of the patients had distant metastases at the time of operation. Severe complications (Dindo-Clavien ≥ 3) occurred in 56 (14.9%) patients, and 4 (1.1%) patients died perioperatively. Severe complications were more frequent in surgery for duodenopancreatic NENs (n = 31; 22.0%) compared with SI-NENs (n = 15; 11.4%) (p = 0.014), in patients with lymph node metastases operated with curative aim of surgery (n = 24; 21.4%) versus non-metastasized tumors or palliative surgery (n = 32; 12.1%) (p = 0.020), and in functioning tumors (n = 20; 23.0%) versus non-functioning tumors (n = 30; 13.5%) (p = 0.042). Complication rates were not significantly associated with tumor stage or grade. Conclusions: Severe complications are frequent in GEP-NEN surgery. Besides duodenopancreatic tumor location, curative resection of nodal metastases and functioning tumors are risk factors for complications. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Gastro-entero-pancreatic system, Neuroendocrine neoplasia, Pancreas, Perioperative complications, Small intestine, Surgery
in
Langenbeck's Archives of Surgery
volume
405
issue
2
pages
7 pages
publisher
Springer
external identifiers
  • pmid:32291468
  • scopus:85083770080
ISSN
1435-2443
DOI
10.1007/s00423-020-01869-0
language
English
LU publication?
yes
id
1c02d300-1ed1-41ac-b433-4e9133937450
date added to LUP
2020-05-28 13:06:02
date last changed
2024-11-01 05:02:12
@article{1c02d300-1ed1-41ac-b433-4e9133937450,
  abstract     = {{Purpose: Surgery is recommended for most patients with gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NENs). Rates of complications and perioperative mortality have been reported in few mostly retrospective single-center series, but there has been no detailed analysis on risk factors for perioperative complications and mortality to date. Methods: Data of patients with GEP-NENs operated between January 2015 and September 2018 were retrieved from EUROCRINE©, a European online endocrine surgical quality registry, and analyzed regarding rate and risk factors of surgical complications. Risk factors were assessed by logistic regression. Results: Some 376 patients (211 female, 167 male; age median 63, range 15–89 years) were included. Most NENs were located in the small intestine (SI) (n = 132) or pancreas (n = 111), the rest in the stomach (n = 34), duodenum (n = 30), appendix (n = 30), colon, and rectum (n = 22), or with unknown primary (n = 15). Of the tumors, 320 (85.1%) were well or moderately differentiated, and 147 (39.1%) of the patients had distant metastases at the time of operation. Severe complications (Dindo-Clavien ≥ 3) occurred in 56 (14.9%) patients, and 4 (1.1%) patients died perioperatively. Severe complications were more frequent in surgery for duodenopancreatic NENs (n = 31; 22.0%) compared with SI-NENs (n = 15; 11.4%) (p = 0.014), in patients with lymph node metastases operated with curative aim of surgery (n = 24; 21.4%) versus non-metastasized tumors or palliative surgery (n = 32; 12.1%) (p = 0.020), and in functioning tumors (n = 20; 23.0%) versus non-functioning tumors (n = 30; 13.5%) (p = 0.042). Complication rates were not significantly associated with tumor stage or grade. Conclusions: Severe complications are frequent in GEP-NEN surgery. Besides duodenopancreatic tumor location, curative resection of nodal metastases and functioning tumors are risk factors for complications.}},
  author       = {{Albers, Max B. and Almquist, Martin and Bergenfelz, Anders and Nordenström, Erik}},
  issn         = {{1435-2443}},
  keywords     = {{Gastro-entero-pancreatic system; Neuroendocrine neoplasia; Pancreas; Perioperative complications; Small intestine; Surgery}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  pages        = {{137--143}},
  publisher    = {{Springer}},
  series       = {{Langenbeck's Archives of Surgery}},
  title        = {{Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias}},
  url          = {{http://dx.doi.org/10.1007/s00423-020-01869-0}},
  doi          = {{10.1007/s00423-020-01869-0}},
  volume       = {{405}},
  year         = {{2020}},
}