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Multicenter Study
. 2024 Jul;31(7):4551-4557.
doi: 10.1245/s10434-024-15328-3. Epub 2024 Apr 28.

Presacral Neuroendocrine Neoplasms: A Multi-site Review of Surgical Outcomes

Tommaso Violante  1   2 , Brenda Murphy  1 , Davide Ferrari  1   2   3 , Rondell P Graham  4 , Patrick Navin  5 , Amit Merchea  6 , David W Larson  1 , Eric J Dozois  1 , Thorvardur R Halfdanarson  7 , William R Perry  8
Affiliations
Multicenter Study

Presacral Neuroendocrine Neoplasms: A Multi-site Review of Surgical Outcomes

Tommaso Violante et al. Ann Surg Oncol. 2024 Jul.

Abstract

Introduction: Presacral neuroendocrine neoplasms (PNENs) are rare tumors, with limited data on management and outcomes.

Methods: A retrospective review of institutional medical records was conducted to identify all patients with PNENs between 2008 and 2022. Data collection included demographics, symptoms, imaging, surgical approaches, pathology, complications, and long-term outcomes.

Results: Twelve patients were identified; two-thirds were female, averaging 44.8 years of age, and, for the most part, presenting with back pain, constipation, and abdominal discomfort. Preoperative imaging included computed tomography scans and magnetic resonance images, with somatostatin receptor imaging and biopsies being common. Half of the patients had metastatic disease on presentation. Surgical approach varied, with anterior, posterior, and combined techniques used, often involving muscle transection and coccygectomy. Short-term complications affected one-quarter of patients. Pathologically, PNENs were mainly well-differentiated grade 2 tumors with positive synaptophysin and chromogranin A. Associated anomalies were common, with tail-gut cysts prevalent. Mean tumor diameter was 6.3 cm. Four patients received long-term adjuvant therapy. Disease progression necessitated additional interventions, including surgery and various chemotherapy regimens. Skeletal, liver, thyroid, lung, and pancreatic metastases occurred during follow-up, with no mortality reported. Kaplan-Meier analysis showed a 5-year local recurrence rate of 23.8%, disease progression rate of 14.3%, and de novo metastases rate of 30%.

Conclusion: The study underscores the complex management of PNENs and emphasizes the need for multicenter research to better understand and manage these tumors. It provides valuable insights into surgical outcomes, recurrence rates, and overall survival, guiding future treatment strategies for PNEN patients.

Keywords: Neuroendocrine; Presacral tumor; Recurrence; Surgery.

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References

    1. Ghosh J, Eglinton T, Frizelle FA, Watson AJ. Presacral tumours in adults. Surgeon. 2007;5(1):31–8. - PubMed - DOI
    1. Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM. Retrorectal tumors. Mayo Clinic experience, 1960–1979. Dis Colon Rectum. 1985;28(9):644–52. - PubMed - DOI
    1. Hobson KG, Ghaemmaghami V, Roe JP, Goodnight JE, Khatri VP. Tumors of the retrorectal space. Dis Colon Rectum. 2005;48(10):1964–74. - PubMed - DOI
    1. Messick CA, Hull T, Rosselli G, Kiran RP. Lesions originating within the retrorectal space: a diverse group requiring individualized evaluation and surgery. J Gastrointest Surg. 2013;17(12):2143–52. - PubMed - DOI
    1. Spencer RJ, Jackman RJ. Surgical management of precoccygeal cysts. Surg Gynecol Obstet. 1962;115:449–52. - PubMed

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