Systematic review of resecting primary tumor in MNETs patients with unresectable liver metastases
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Jingfei Guo1,2,*, Qian Zhang3,*, Xinyu Bi1, Jianguo Zhou1, Zhiyu Li1, Zhen Huang1, Yefan Zhang1, Muxing Li1, Xiao Chen1, Xuhui Hu1, Chi Yihebali4, Junbo Liang5, Jianmei Liu6, Jianjun Zhao1, Jianqiang Cai1, Hong Zhao1
1Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
2Academy of Medical Sciences, Peking Union Medical College, Beijing, China
3Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
4Department of Internal Medicine, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
5State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
6Laboratory of Cell and Molecular Biology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
*These authors have contributed equally to this work
Hong Zhao, email: firstname.lastname@example.org
Jianqiang Cai, email: email@example.com
Jianjun Zhao, email: firstname.lastname@example.org
Keywords: midgut neuroendocrine tumor, liver metastasis, palliative surgery, primary tumor resection, survival benefit
Received: August 15, 2016 Accepted: November 07, 2016 Published: December 24, 2016
Background: Treatment for midgut neuroendocrine tumor patients with unresectable liver metastasis has long been a controversial issue. This system review aims to summarize existing evidence concerning the value of primary tumor resection in this group of patients.
Results: 8 cohort studies were identified for qualitative analysis. None of them strictly met with the inclusion criteria and meta-analysis was impossible. There was a tendency towards better overall survival for the primary tumor resected group in all 8 studies, in which 6 demonstrated significant difference. Progression free survival to liver disease was prolonged and less patients died of liver failure in the resected group.
Methods: MEDLINE, EMBASE and CENTRAL were searched until 2016/7/4 for relevant studies, with primary outcome being overall survival, and secondary outcome being progression free survival, cause of death and symptom relief.
Conclusions: Current evidence supports resection of primary tumor for midgut neuroendocrine tumor patients with liver metastases, but randomized controlled trials are required to reach a final conclusion.
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