05 Mar 2014
A significant number of patients with small bowel neuroendocrine tumours (NETS) develop metastatic disease during the course of their disease. Complete surgical resection of the patient’s primary tumour and metastatic disease is is often the only available cure. Many patients undergo multiple surgeries to achieve the lowest possible disease burden. This paper is a retrospective analysis from a single centre assessing the complication and survival rates of patients with metastatic small bowel NETs undergoing surgical cytoreduction.
The medical notes of 189 patients were reviewed, on which a total of 229 surgeries were performed. 10% of cases required blood transfusion during procedure. Intra-operative complications included myocardial infarction in one case and cardiovascular instability due to anaesthesia in another.
3 patients died post-operatively in ICU. The medication duration of stay was 4 days (range 0-23 days). Over 2/3 of patients had no complications and the majority that developed complications were only minor complications in nature. The 30 day post-operative death rate was 3%. The 5, 10 and 20 years Kaplan-Meier survival rates from diagnosis were 87%, 77% and 41% respectively.
In summary, cytoreductive surgery in metastatic small bowel NETs appears to have a low morbidity and mortality rate. The survival seems prolonged, however, this is not a direct comparison with a control group.
Source: Journal of the American College of Surgeons (published study)