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. 2023 Nov 23;23(1):408.
doi: 10.1186/s12876-023-03041-6.

Resection of the primary tumor improves the prognosis of gastrointestinal neuroendocrine neoplasms with liver metastases: mutual validation based on SEER database and institutional data

Yifan Liu #  1 , Zhixiong Wang #  1 , Qi Lin #  1 , Ruizhe Cui  1 , Wei Tang  1 , Guanghua Li  2 , Zhao Wang  3
Affiliations

Resection of the primary tumor improves the prognosis of gastrointestinal neuroendocrine neoplasms with liver metastases: mutual validation based on SEER database and institutional data

Yifan Liu et al. BMC Gastroenterol. .

Abstract

Background: Gastrointestinal Neuroendocrine Neoplasms (GI-NENs) often result in liver metastases, and the role of Primary Tumor Resection (PTR) in managing GI-NENs with liver metastases (GI-NENLM) is still debated. This study aimed to investigate the potential benefits of PTR in treating GI-NENLM by analyzing data from the Surveillance, Epidemiology, and End Results Program (SEER) and the First Affiliated Hospital of Sun Yat-sen University (FAH).

Methods: The SEER Registry 17 database and the FAH clinical pathology database were used to collect clinicopathology data for GI-NENLM diagnosed between 2010 and 2019 and between 2011 and 2022, respectively. Propensity score matching (PSM) was used to match the clinicopathological characteristics of patients from both cohorts. Inverse probability weighting (IPTW) was used to weigh the PTR and non-PTR groups. The primary endpoint was overall survival (OS).

Results: After matching, 155 patients from the SEER database were matched to the FAH cohort. PTR was significantly associated with better prognosis in PSM-matched/unmatched SEER cohorts (P < 0.01) and in the FAH cohort even after eliminating selection bias using IPTW (p < 0.01). Subgroup analysis suggests that the cohort consisting of patients aged 55 years or older, individuals with colorectal primary tumors, those at the T1 disease stage, and those without extrahepatic metastasis may potentially benefit from PTR. Interaction analysis showed no significant interaction between PTR and other clinical and pathological factors except for age.

Conclusion: The employment of PTR in patients with GI-NENLM is significantly correlated with individual survival benefits. We support performing PTR on carefully evaluated patients.

Keywords: Gastrointestinal; Liver metastasis; Neuroendocrine neoplasm; Primary tumor resection; SEER.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient-selection flowchart of FAH cohort (a) and SEER cohort (b)
Fig. 2
Fig. 2
Overall survival of patients with and without PTR. a Overall survival of pre-PSM SEER cohort before IPTW stratified by with and without PTR. b Overall survival of post-PSM SEER cohort before IPTW stratified by with and without PTR. c Overall survival of FAH cohort before IPTW stratified by with and without PTR. d Overall survival of pre-PSM SEER cohort after IPTW stratified by with and without PTR. e Overall survival of post-PSM SEER cohort after IPTW stratified by with and without PTR. f Overall survival of FAH cohort after IPTW stratified by with and without PTR
See this image and copyright information in PMC

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