Surgical management of metastatic neuroendocrine tumors:beyond the realm of evidence-based medicine  

作　　者：Jonathan R.Strosberg Taymeyah Al-Toubah 

机构地区：[1]Department of Gastrointestinal Oncology,Moffitt Cancer Center&Research Institute,University of South Florida,Tampa,FL,USA

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第3期551-553,共3页肝胆外科与营养（英文）

摘　　要：How strong is the evidence supporting surgery for patients with metastatic neuroendocrine tumors(NETs)?This is the chief question from Dr.Williams’comprehensive and balanced literature analysis on the surgical treatment of metastatic pancreatic NETs(1).No matter how many non-randomized studies demonstrate a survival advantage for patients undergoing cytoreductive hepatic surgery or resection of the primary pancreatic tumor,the methodological biases remain constant(2-9).Patients undergoing surgery tend to be younger and healthier,and their tumors tend to be lower grade,less aggressive,and fewer in number than patients undergoing other systemic or liver-directed therapies.In other words,the survival advantage begins when the patient is selected as a surgical candidate and before the scalpel even touches the skin.Although multivariate analyses can control for some confounding variables,it is impossible to control for all.Even a simple concept such as tumor burden is challenging to standardize:a patient with a few large tumors confined to a single hepatic lobe may have a vastly different prognosis than a patient with a similar burden of miliary tumors scattered throughout the liver(2).

关 键 词：Neuroendocrine tumor(NET) CYTOREDUCTION DEBULKING surgery TRANSPLANTATION 

分 类 号：R735[医药卫生—肿瘤]