Impact of surgical approach on short- and long-term outcomes in gastroenteropancreatic neuroendocrine carcinomas

Qichen Chen; Kristen E Rhodin; Kan Li; Elishama Kanu; Sabino Zani; Michael E Lidsky; Jianjun Zhao; Qingyi Wei; Sheng Luo; Hong Zhao

doi:10.1016/j.hpb.2023.06.008

Impact of surgical approach on short- and long-term outcomes in gastroenteropancreatic neuroendocrine carcinomas

HPB (Oxford). 2023 Oct;25(10):1255-1267. doi: 10.1016/j.hpb.2023.06.008. Epub 2023 Jun 13.

Authors

Qichen Chen¹, Kristen E Rhodin², Kan Li³, Elishama Kanu², Sabino Zani², Michael E Lidsky², Jianjun Zhao⁴, Qingyi Wei⁵, Sheng Luo⁶, Hong Zhao⁷

Affiliations

¹ Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China; Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710, USA.
² Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA.
³ Merck & Co., Inc., Rahway, NJ, USA.
⁴ Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China.
⁵ Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710, USA; Department of Population Health Science, Duke University School of Medicine, Durham, NC 27110, USA; Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA; Duke Global Health Institute, Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: qingyi.wei@duke.edu.
⁶ Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: sheng.luo@duke.edu.
⁷ Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China. Electronic address: zhaohong@cicams.ac.cn.

PMID: 37414710
DOI: 10.1016/j.hpb.2023.06.008

Abstract

Background: Literature is lacking on the impact of advancements in minimally invasive surgery (MIS) on outcomes for patients with gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs). Herein, we compared perioperative and oncologic outcomes among patients with GEP-NECs undergoing open, laparoscopic, and robotic resection.

Methods: Patients with GEP-NECs diagnosed 2010-2019 were identified from the National Cancer Database (NCDB). We used the inverse probability of treatment weighting method to account for selection bias. Patients were stratified by surgical approach; and pairwise comparisons were conducted by analyzing short- and long-term outcomes.

Results: Receipt of MIS increased from 34.2% in 2010 to 67.5 % in 2019. Altogether, 6560 patients met study criteria: 3444 (52.5%) underwent open resection, 2783 (42.4%) underwent laparoscopic resection and 333 (5.1%) underwent robotic resection. Compared with open resection, laparoscopic or robotic resection were associated with shorter post-operative length of stay, reduced 30-day and 90-day post-operative mortality, and prolonged overall survival (OS). Compared with laparoscopic resection, robotic resection was associated with reduced 90-day post-operative mortality, however, there was no significant difference in OS.

Conclusion: This NCDB analysis demonstrates that MIS approaches for treating GEP-NECs have become more common, with improved perioperative mortality, shorter post-operative length of stay and favorable OS, compared with open resection.