Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study
Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study
复制标题
非功能性胰腺神经内分泌肿瘤患者摘除术与常规胰腺切除术的临床结果比较：一项回顾性多中心倾向评分匹配研究
DOI：
10.1093/jjco/hyaa246
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发表时间：
2021
影响因子：
2.4
通讯作者：
Zhou Xu
中科院分区：
文献类型：
--
作者：
Yang Zhen;Gao Hengjun;Lu Jun;Niu Zheyu;Zhu Huaqiang;Zong Yuanyuan;Song Xie;Yang Faji;Zhou Xu
回顾性研究中关于常规胰腺切除术后的治疗结果是否上级小的、外周的和分化良好的无功能性胰腺神经内分泌肿瘤患者的摘除术后的治疗结果的数据有限。本研究旨在比较常规胰腺切除术和摘除术在非功能性胰腺神经内分泌tumors.MethodsBetween 2007年1月和2020年7月的短期和长期结果，227例非功能性胰腺神经内分泌肿瘤患者接受了摘除术（n= 89）或常规胰腺切除术（n= 138）。比较围手术期并发症、无病生存率和总生存概率。倾向评分匹配进行平衡两组之间的基线differences.ResultsThe中位随访期为60.76个月的摘除组和43.29个月的常规胰腺切除术组。在倾向评分匹配后，共确定了34例配对患者。平均手术时间：147.94 ± 42.39 min，常规胰腺切除术组217.94 ± 74.60 min，两组比较差异有统计学意义（P< 0.001），术中出血量也明显减少（P< 0.001）。与接受常规胰腺切除术的患者相比，接受眼球摘除术的患者术后并发症的总体发生率相似（P= 0.765），住院时间相似（11.12 ± 3.90天vs 9.94 ± 2.62天，P= 0.084）。两组之间无病生存率和总生存率无统计学显著差异后，倾向评分matching.ConclusionEnucleation与非功能性胰腺神经内分泌肿瘤患者的手术时间较短，术中出血较少，术后并发症的总体发病率相似，可比的5年无病生存率和总生存率相比，定期胰腺切除术。
ObjectiveThere are limited data from retrospective studies on whether therapeutic outcomes after regular pancreatectomy are superior to those after enucleation in patients with small, peripheral and well-differentiated non-functional pancreatic neuroendocrine tumors. This study aimed to compare the short- and long-term outcomes of regular pancreatectomy and enucleation in patients with non-functional pancreatic neuroendocrine tumors.MethodsBetween January 2007 and July 2020, 227 patients with non-functional pancreatic neuroendocrine tumors who underwent either enucleation (n= 89) or regular pancreatectomy (n= 138) were included. Perioperative complications, disease-free survival, and overall survival probabilities were compared. Propensity score matching was performed to balance the baseline differences between the two groups.ResultsThe median follow-up period was 60.76 months in the enucleation group and 43.29 months in the regular pancreatectomy group. In total, 34 paired patients were identified after propensity score matching. The average operative duration in the enucleation group was significantly shorter than that in the regular pancreatectomy group (147.94 ± 42.39 min versus 217.94 ± 74.60 min,P< 0.001), and the estimated blood loss was also significantly lesser (P< 0.001). The matched patients who underwent enucleation displayed a similar overall incidence of postoperative complications (P= 0.765), and a comparable length of hospital stay (11.12 ± 3.90 days versus 9.94 ± 2.62 days,P= 0.084) compared with those who underwent regular pancreatectomy. There were no statistically significant differences between the two groups in disease-free survival and overall survival after propensity score matching.ConclusionEnucleation in patients with non-functional pancreatic neuroendocrine tumors was associated with shorter operative time, lesser intraoperative bleeding, similar overall morbidity of postoperative complications, and comparable 5-year disease-free survival and overall survival when compared with regular pancreatectomy.