Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon : meta-analysis

Van Den Heede, Klaas LU orcid ; Chidambaram, Swathikan ; Van Slycke, Sam ; Brusselaers, Nele ; Warfvinge, Carl Fredrik LU ; Ohlsson, Håkan LU orcid ; Nordenström, Erik LU and Almquist, Martin LU (2022) In The British journal of surgery 109(2). p.191-199
Abstract

BACKGROUND: Patients with small intestinal neuroendocrine tumours (siNETs) usually present with advanced disease. Primary tumour resection without curative intent is controversial in patients with metastatic siNETs. The aim of this meta-analysis was to investigate survival after primary tumour resection without curative intent compared with no resection in patients with metastatic siNETs. METHODS: A systematic literature search was performed, using MEDLINE® (PubMed), Embase®, Web of Science, and the Cochrane Library up to 25 February 2021. Studies were included if survival after primary tumour resection versus no resection in patients with metastatic siNETs was reported. Results were pooled in a random-effects meta-analysis, and are... (More)

BACKGROUND: Patients with small intestinal neuroendocrine tumours (siNETs) usually present with advanced disease. Primary tumour resection without curative intent is controversial in patients with metastatic siNETs. The aim of this meta-analysis was to investigate survival after primary tumour resection without curative intent compared with no resection in patients with metastatic siNETs. METHODS: A systematic literature search was performed, using MEDLINE® (PubMed), Embase®, Web of Science, and the Cochrane Library up to 25 February 2021. Studies were included if survival after primary tumour resection versus no resection in patients with metastatic siNETs was reported. Results were pooled in a random-effects meta-analysis, and are reported as hazard ratios (HRs) with 95 per cent confidence intervals. Sensitivity analyses were undertaken to enable comment on the impact of important confounders. RESULTS: After screening 3659 abstracts, 16 studies, published between 1992 and 2021, met the inclusion criteria, with a total of 9428 patients. Thirteen studies reported HRs adjusted for important confounders and were included in the meta-analysis. Median overall survival was 112 (i.q.r. 82-134) months in the primary tumour resection group compared with 60 (74-88) months in the group without resection. Five-year overall survival rates were 74 (i.q.r. 67-77) and 44 (34-45) per cent respectively. Primary tumour resection was associated with improved survival compared with no resection (HR 0.55, 95 per cent c.i. 0.47 to 0.66). This effect remained in sensitivity analyses. CONCLUSION: Primary tumour resection is associated with increased survival in patients with advanced, metastatic siNETs, even after adjusting for important confounders.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The British journal of surgery
volume
109
issue
2
pages
9 pages
publisher
Oxford University Press
external identifiers
  • pmid:34941998
  • scopus:85123969135
ISSN
1365-2168
DOI
10.1093/bjs/znab413
language
English
LU publication?
yes
id
e65728a8-f733-4d55-a3a3-1f0df870e560
date added to LUP
2022-04-07 14:58:01
date last changed
2024-06-07 09:28:14
@article{e65728a8-f733-4d55-a3a3-1f0df870e560,
  abstract     = {{<p>BACKGROUND: Patients with small intestinal neuroendocrine tumours (siNETs) usually present with advanced disease. Primary tumour resection without curative intent is controversial in patients with metastatic siNETs. The aim of this meta-analysis was to investigate survival after primary tumour resection without curative intent compared with no resection in patients with metastatic siNETs. METHODS: A systematic literature search was performed, using MEDLINE® (PubMed), Embase®, Web of Science, and the Cochrane Library up to 25 February 2021. Studies were included if survival after primary tumour resection versus no resection in patients with metastatic siNETs was reported. Results were pooled in a random-effects meta-analysis, and are reported as hazard ratios (HRs) with 95 per cent confidence intervals. Sensitivity analyses were undertaken to enable comment on the impact of important confounders. RESULTS: After screening 3659 abstracts, 16 studies, published between 1992 and 2021, met the inclusion criteria, with a total of 9428 patients. Thirteen studies reported HRs adjusted for important confounders and were included in the meta-analysis. Median overall survival was 112 (i.q.r. 82-134) months in the primary tumour resection group compared with 60 (74-88) months in the group without resection. Five-year overall survival rates were 74 (i.q.r. 67-77) and 44 (34-45) per cent respectively. Primary tumour resection was associated with improved survival compared with no resection (HR 0.55, 95 per cent c.i. 0.47 to 0.66). This effect remained in sensitivity analyses. CONCLUSION: Primary tumour resection is associated with increased survival in patients with advanced, metastatic siNETs, even after adjusting for important confounders.</p>}},
  author       = {{Van Den Heede, Klaas and Chidambaram, Swathikan and Van Slycke, Sam and Brusselaers, Nele and Warfvinge, Carl Fredrik and Ohlsson, Håkan and Nordenström, Erik and Almquist, Martin}},
  issn         = {{1365-2168}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{191--199}},
  publisher    = {{Oxford University Press}},
  series       = {{The British journal of surgery}},
  title        = {{Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon : meta-analysis}},
  url          = {{http://dx.doi.org/10.1093/bjs/znab413}},
  doi          = {{10.1093/bjs/znab413}},
  volume       = {{109}},
  year         = {{2022}},
}