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Decreasing utilization of surgical interventions amongst patients with pancreatic neuroendocrine tumor with liver metastases
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Decreasing utilization of surgical interventions amongst patients with pancreatic neuroendocrine tumor with liver metastases
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Journal Article
Decreasing utilization of surgical interventions amongst patients with pancreatic neuroendocrine tumor with liver metastases
2024
Overview
Since 2013, North American Neuroendocrine Tumor Society (NANETS) consensus-guidelines have endorsed consideration of surgical intervention for pancreatic- neuroendocrine tumors (PNET) with liver metastases.
Patients with non-functional PNET with liver only metastases from 2010 to 2019 were identified from the National Cancer Database.
34.7% underwent surgical intervention (13% PNET resection, 2.1% surgical management of liver metastases (SMLM), 19.5% PNET resection + SMLM). In multivariable analysis, government insurance, year of diagnosis>2013, increasing primary tumor size were associated with lower rate of surgical intervention. Receiving treatment at an academic center (OR 3.59, 95%CI 1.81–7.11; P < 0.001) or integrated cancer network (OR 3.21, 95%CI 1.57–6.54; P = 0.001) was associated with a higher rate of surgical intervention. The overall rate of surgical intervention decreased from 45.7% in 2010 to 23.0% in 2019.
Despite guideline recommendations and the suggested survival benefits, only one-third of patients underwent surgical intervention, potentially influenced by the rising utilization of systemic therapy in the past decade.
•One-third of patients with PNET and liver metastases received surgical intervention.•Overall rate of surgical intervention for patients with PNET +liver metastases decreased from 45.7% in 2010 to 23.0% in 2019.•Treatment in community centers compared to academic centers was associated with lower chance of surgical intervention.•5-year OS non-surgical patients 40.4%, vs. PNET resection 74.4% vs. both SMLM and PNET resection 75.9%.
Publisher
Elsevier Inc,Elsevier Limited
