TY - JOUR
T1 - Preoperative Fluorouracil, Doxorubicin, and Streptozocin for the Treatment of Pancreatic Neuroendocrine Liver Metastases
AU - Cloyd, Jordan M.
AU - Omichi, Kiyohiko
AU - Mizuno, Takashi
AU - Kawaguchi, Yoshikuni
AU - Tzeng, Ching Wei D.
AU - Conrad, Claudius
AU - Chun, Yun Shin
AU - Aloia, Thomas A.
AU - Katz, Matthew H.G.
AU - Lee, Jeffrey E.
AU - Halperin, Daniel
AU - Yao, James
AU - Vauthey, Jean Nicolas
AU - Dasari, Arvind
N1 - Publisher Copyright:
© 2018, Society of Surgical Oncology.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Introduction: While preoperative chemotherapy is frequently utilized before resection of non-neuroendocrine liver metastases, patients with resectable neuroendocrine liver metastases typically undergo surgery first. FAS is a cytotoxic chemotherapy regimen that is associated with substantial response rates in locally advanced and metastatic pancreatic neuroendocrine tumors. Methods: All patients who underwent R0/R1 resection of pancreatic neuroendocrine liver metastases at a single institution between 1998 and 2015 were included. The outcomes of patients treated with preoperative FAS were compared with those of patients who were not. Results: Of the 67 patients included, 27 (40.3%) received preoperative FAS, whereas 40 (59.7%) did not. Despite being associated with higher rates of synchronous disease, lymph node metastases, and larger tumor size, patients who received preoperative FAS had similar overall survival [overall survival (OS), 108.2 months (95% confidence interval (CI) 78.0–136.0) vs. 107.0 months (95% CI 78.0–136.0), p = 0.64] and recurrence-free survival [RFS, 25.1 months (95% CI 23.2–27.0) vs. 18.0 months (95% CI 13.8–22.2), p = 0.16] as patients who did not. Among patients who presented with synchronous liver metastases (n = 46), the median OS [97.3 months (95% CI 65.9–128.6) vs. 65.0 months (95% CI 28.1–101.9), p = 0.001] and RFS [24.8 months (95% CI 22.6–26.9) vs. 12.1 months (2.2–22.0), p = 0.003] were significantly greater among patients who received preoperative FAS compared with those who did not. Conclusions: The use of FAS before liver resection is associated with improved OS compared with surgery alone among patients with advanced synchronous pancreatic neuroendocrine liver metastases.
AB - Introduction: While preoperative chemotherapy is frequently utilized before resection of non-neuroendocrine liver metastases, patients with resectable neuroendocrine liver metastases typically undergo surgery first. FAS is a cytotoxic chemotherapy regimen that is associated with substantial response rates in locally advanced and metastatic pancreatic neuroendocrine tumors. Methods: All patients who underwent R0/R1 resection of pancreatic neuroendocrine liver metastases at a single institution between 1998 and 2015 were included. The outcomes of patients treated with preoperative FAS were compared with those of patients who were not. Results: Of the 67 patients included, 27 (40.3%) received preoperative FAS, whereas 40 (59.7%) did not. Despite being associated with higher rates of synchronous disease, lymph node metastases, and larger tumor size, patients who received preoperative FAS had similar overall survival [overall survival (OS), 108.2 months (95% confidence interval (CI) 78.0–136.0) vs. 107.0 months (95% CI 78.0–136.0), p = 0.64] and recurrence-free survival [RFS, 25.1 months (95% CI 23.2–27.0) vs. 18.0 months (95% CI 13.8–22.2), p = 0.16] as patients who did not. Among patients who presented with synchronous liver metastases (n = 46), the median OS [97.3 months (95% CI 65.9–128.6) vs. 65.0 months (95% CI 28.1–101.9), p = 0.001] and RFS [24.8 months (95% CI 22.6–26.9) vs. 12.1 months (2.2–22.0), p = 0.003] were significantly greater among patients who received preoperative FAS compared with those who did not. Conclusions: The use of FAS before liver resection is associated with improved OS compared with surgery alone among patients with advanced synchronous pancreatic neuroendocrine liver metastases.
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U2 - 10.1245/s10434-018-6468-8
DO - 10.1245/s10434-018-6468-8
M3 - Article
C2 - 29626307
AN - SCOPUS:85045033282
SN - 1068-9265
VL - 25
SP - 1709
EP - 1715
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 6
ER -