1. Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1-2 cm in size : a retrospective, Europe-wide, pooled cohort study
- Author
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Nesti, Cedric, Bräutigam, Konstantin, Benavent, Marta, Bernal, Laura, Boharoon, Hessa, Botling, Johan, Bouroumeau, Antonin, Brcic, Iva, Brunner, Maximilian, Cadiot, Guillaume, Camara, Maria, Christ, Emanuel, Clerici, Thomas, Clift, Ashley K., Clouston, Hamish, Cobianchi, Lorenzo, Cwikla, Jaroslaw B., Daskalakis, Kosmas, Frilling, Andrea, Garcia-Carbonero, Rocio, Grozinsky-Glasberg, Simona, Hernando, Jorge, Hervieu, Valerie, Hofland, Johannes, Holmager, Pernille, Inzani, Frediano, Jann, Henning, Jimenez-Fonseca, Paula, Kacmaz, Enes, Kaemmerer, Daniel, Kaltsas, Gregory, Klimàcek, Branislav, Knigge, Ulrich, Kolasinska-Cwikla, Agnieszka, Kolb, Walter, Kos-Kudla, Beata, Kunze, Catarina Alisa, Landolfi, Stefania, La Rosa, Stefano, Lopez, Carlos Lopez, Lorenz, Kerstin, Matter, Maurice, Mazal, Peter, Mestre-Alagarda, Claudia, del Burgo, Patricia Morales, van Dijkum, Els J. M. Nieveen, Oleinikov, Kira, Orci, Lorenzo A., Panzuto, Francesco, Pavel, Marianne, Perrier, Marine, Reims, Henrik Mikael, Rindi, Guido, Rinke, Anja, Rinzivillo, Maria, Sagaert, Xavier, Satiroglu, Ilker, Selberherr, Andreas, Siebenhuener, Alexander R., Tesselaar, Margot E. T., Thalhammer, Michael J., Thiis-Evensen, Espen, Toumpanakis, Christos, Vandamme, Timon, van den Berg, José G., Vanoli, Alessandro, van Velthuysen, Marie-Louise F., Verslype, Chris, Vorburger, Stephan A., Lugli, Alessandro, Ramage, John, Zwahlen, Marcel, Perren, Aurel, Kaderli, Reto M., Nesti, Cedric, Bräutigam, Konstantin, Benavent, Marta, Bernal, Laura, Boharoon, Hessa, Botling, Johan, Bouroumeau, Antonin, Brcic, Iva, Brunner, Maximilian, Cadiot, Guillaume, Camara, Maria, Christ, Emanuel, Clerici, Thomas, Clift, Ashley K., Clouston, Hamish, Cobianchi, Lorenzo, Cwikla, Jaroslaw B., Daskalakis, Kosmas, Frilling, Andrea, Garcia-Carbonero, Rocio, Grozinsky-Glasberg, Simona, Hernando, Jorge, Hervieu, Valerie, Hofland, Johannes, Holmager, Pernille, Inzani, Frediano, Jann, Henning, Jimenez-Fonseca, Paula, Kacmaz, Enes, Kaemmerer, Daniel, Kaltsas, Gregory, Klimàcek, Branislav, Knigge, Ulrich, Kolasinska-Cwikla, Agnieszka, Kolb, Walter, Kos-Kudla, Beata, Kunze, Catarina Alisa, Landolfi, Stefania, La Rosa, Stefano, Lopez, Carlos Lopez, Lorenz, Kerstin, Matter, Maurice, Mazal, Peter, Mestre-Alagarda, Claudia, del Burgo, Patricia Morales, van Dijkum, Els J. M. Nieveen, Oleinikov, Kira, Orci, Lorenzo A., Panzuto, Francesco, Pavel, Marianne, Perrier, Marine, Reims, Henrik Mikael, Rindi, Guido, Rinke, Anja, Rinzivillo, Maria, Sagaert, Xavier, Satiroglu, Ilker, Selberherr, Andreas, Siebenhuener, Alexander R., Tesselaar, Margot E. T., Thalhammer, Michael J., Thiis-Evensen, Espen, Toumpanakis, Christos, Vandamme, Timon, van den Berg, José G., Vanoli, Alessandro, van Velthuysen, Marie-Louise F., Verslype, Chris, Vorburger, Stephan A., Lugli, Alessandro, Ramage, John, Zwahlen, Marcel, Perren, Aurel, and Kaderli, Reto M.
- Abstract
Background Awareness of the potential global overtreatment of patients with appendiceal neuroendocrine tumours (NETs) of 1–2 cm in size by performing oncological resections is increasing, but the rarity of this tumour has impeded clear recommendations to date. We aimed to assess the malignant potential of appendiceal NETs of 1–2 cm in size in patients with or without right-sided hemicolectomy. Methods In this retrospective cohort study, we pooled data from 40 hospitals in 15 European countries for patients of any age and Eastern Cooperative Oncology Group performance status with a histopathologically confirmed appendiceal NET of 1–2 cm in size who had a complete resection of the primary tumour between Jan 1, 2000, and Dec 31, 2010. Patients either had an appendectomy only or an appendectomy with oncological right-sided hemicolectomy or ileocecal resection. Predefined primary outcomes were the frequency of distant metastases and tumour-related mortality. Secondary outcomes included the frequency of regional lymph node metastases, the association between regional lymph node metastases and histopathological risk factors, and overall survival with or without right-sided hemicolectomy. Cox proportional hazards regression was used to estimate the relative all-cause mortality hazard associated with right-sided hemicolectomy compared with appendectomy alone. This study is registered with ClinicalTrials.gov, NCT03852693. Findings 282 patients with suspected appendiceal tumours were identified, of whom 278 with an appendiceal NET of 1–2 cm in size were included. 163 (59%) had an appendectomy and 115 (41%) had a right-sided hemicolectomy, 110 (40%) were men, 168 (60%) were women, and mean age at initial surgery was 36·0 years (SD 18·2). Median follow-up was 13·0 years (IQR 11·0–15·6). After centralised histopathological review, appendiceal NETs were classified as a possible or probable primary tumour in two (1%) of 278 patients with distant peritoneal metastases and in two (1%
- Published
- 2023
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