Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies
Introduction. The role of hepatic resection in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is still poorly defined. Therefore, we examined the results obtained with surgical resection and other locoregional or systemic therapies by reviewing the recent...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | International Journal of Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2013/235040 |
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| author | Stefano Bacchetti Serena Bertozzi Ambrogio P. Londero Alessandro Uzzau Enrico Maria Pasqual |
| author_facet | Stefano Bacchetti Serena Bertozzi Ambrogio P. Londero Alessandro Uzzau Enrico Maria Pasqual |
| author_sort | Stefano Bacchetti |
| collection | DOAJ |
| description | Introduction. The role of hepatic resection in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is still poorly defined. Therefore, we examined the results obtained with surgical resection and other locoregional or systemic therapies by reviewing the recent literature on this topic. We performed the meta-analysis for comparing surgical resection of hepatic metastases with other treatments. Materials and Methods. In this systematic review and meta-analysis of observational studies, the literature search was undertaken between 1990 and 2012 looking for studies evaluating the different survivals between patients treated with surgical resection of hepatic metastases and with other surgical or nonsurgical therapies. The studies were evaluated for quality, publication bias, and heterogeneity. Pooled hazard ratio (HR) estimates and 95% confidence intervals (CI.95) were calculated using fixed-effects model. Results. We selected six studies in the review, five of which were suitable for meta-analysis. We found a significant longer survival in patients treated with hepatic resection than embolisation HR 0.34 (CI.95 0.21–0.55) or all other nonsurgical treatments HR 0.45 (CI.95 0.34–0.60). Only one study compared surgical resection with liver transplantation and meta-analysis was not feasible. Conclusions. Our meta-analysis provides evidence supporting the hypothesis that hepatic resection increases overall survival in patients with liver metastases from GEP-NETs. Further randomized clinical trials are needed to confirm these findings and it would be desirable to identify new markers to properly select patients for surgical treatment. |
| format | Article |
| id | doaj-art-19eaa0a369e0420e8652b2db70759b1f |
| institution | Kabale University |
| issn | 2090-3448 2090-3456 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hepatology |
| spelling | doaj-art-19eaa0a369e0420e8652b2db70759b1f2025-02-03T01:11:11ZengWileyInternational Journal of Hepatology2090-34482090-34562013-01-01201310.1155/2013/235040235040Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational StudiesStefano Bacchetti0Serena Bertozzi1Ambrogio P. Londero2Alessandro Uzzau3Enrico Maria Pasqual4Department of Surgery, AOU “Santa Maria della Misericordia”, Piazzale SM della Misericordia 15, I-33100 Udine, ItalyDepartment of Surgery, AOU “Santa Maria della Misericordia”, Piazzale SM della Misericordia 15, I-33100 Udine, ItalyUniversity of Udine and AOU “Santa Maria della Misericordia”, Piazzale SM della Misericordia 15, I-33100 Udine, ItalyDepartment of Surgery, AOU “Santa Maria della Misericordia”, Piazzale SM della Misericordia 15, I-33100 Udine, ItalyDepartment of Surgery, AOU “Santa Maria della Misericordia”, Piazzale SM della Misericordia 15, I-33100 Udine, ItalyIntroduction. The role of hepatic resection in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is still poorly defined. Therefore, we examined the results obtained with surgical resection and other locoregional or systemic therapies by reviewing the recent literature on this topic. We performed the meta-analysis for comparing surgical resection of hepatic metastases with other treatments. Materials and Methods. In this systematic review and meta-analysis of observational studies, the literature search was undertaken between 1990 and 2012 looking for studies evaluating the different survivals between patients treated with surgical resection of hepatic metastases and with other surgical or nonsurgical therapies. The studies were evaluated for quality, publication bias, and heterogeneity. Pooled hazard ratio (HR) estimates and 95% confidence intervals (CI.95) were calculated using fixed-effects model. Results. We selected six studies in the review, five of which were suitable for meta-analysis. We found a significant longer survival in patients treated with hepatic resection than embolisation HR 0.34 (CI.95 0.21–0.55) or all other nonsurgical treatments HR 0.45 (CI.95 0.34–0.60). Only one study compared surgical resection with liver transplantation and meta-analysis was not feasible. Conclusions. Our meta-analysis provides evidence supporting the hypothesis that hepatic resection increases overall survival in patients with liver metastases from GEP-NETs. Further randomized clinical trials are needed to confirm these findings and it would be desirable to identify new markers to properly select patients for surgical treatment.http://dx.doi.org/10.1155/2013/235040 |
| spellingShingle | Stefano Bacchetti Serena Bertozzi Ambrogio P. Londero Alessandro Uzzau Enrico Maria Pasqual Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies International Journal of Hepatology |
| title | Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies |
| title_full | Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies |
| title_fullStr | Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies |
| title_full_unstemmed | Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies |
| title_short | Surgical Treatment and Survival in Patients with Liver Metastases from Neuroendocrine Tumors: A Meta-Analysis of Observational Studies |
| title_sort | surgical treatment and survival in patients with liver metastases from neuroendocrine tumors a meta analysis of observational studies |
| url | http://dx.doi.org/10.1155/2013/235040 |
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