Current Management and Predictive Factors of Lymph Node Metastasis of Appendix Neuroendocrine Tumors : A National Study from the French Group of Endocrine Tumors (GTE) - Université de Montpellier Accéder directement au contenu
Article Dans Une Revue Annals of Surgery Année : 2019

Current Management and Predictive Factors of Lymph Node Metastasis of Appendix Neuroendocrine Tumors : A National Study from the French Group of Endocrine Tumors (GTE)

Antoine Tabarin
  • Fonction : Auteur
  • PersonId : 944557
Pierre Goudet
  • Fonction : Auteur
Thomas Walter

Résumé

OBJECTIVE: The primary endpoint was to analyze the predictive factors of lymph node involvement (LN+). BACKGROUND: Indications for additional right hemicolectomy (RHC) with lymph node (LN) resection after appendectomy for appendix neuroendocrine tumor (A-NET) remain controversial, especially for tumors between 1 and 2 cm in size. METHODS: National study including all patients with nonmetastatic A-NET diagnosed after January, 2010 in France. RESULTS: In all, 403 patients were included. A-NETs were: within tip (67%), body (24%) or base (9%) of the appendix; tumor size was < 1 cm (62%), 1 to 2 cm (30%), or >2 cm (8%); grade 1 (91%); mesoappendix involvement 3 mm (5%); lymphovascular (15%) or perineural (24%) invasion; and positive resection margin (8%). According to the European NeuroEndocrine Tumor Society (ENETS) recommendations, 85 patients (21%) should have undergone RHC. The agreement between ENETS guidelines and the multidisciplinary tumor board for complementary RHC was 89%. In all, 100 (25%) patients underwent RHC with LN resection, 26 of whom had LN+. Tumor size (best cut-off at 1.95 cm), lymphovascular and perineural invasion, and pT classifications were associated with LN+. Among the 44 patients who underwent RHC for a tumor of 1 to 2 cm in size, 8 (18%) had LN+. No predictive factor of LN+ (base, resection margins, grade, mesoappendix, lymphovascular, perineural involvement) was found in this subgroup of patients. CONCLUSIONS: In the largest study using the latest pathological criteria for completion RHC in A-NET, a quarter of patients had residual tumor. Further studies are warranted to demonstrate the survival impact of RHC in this setting.
Fichier non déposé

Dates et versions

hal-02547901 , version 1 (20-04-2020)

Identifiants

Citer

Bérénice Rault-Petit, Christine Do Cao, Serge Guyétant, Rosine Guimbaud, Vincent Rohmer, et al.. Current Management and Predictive Factors of Lymph Node Metastasis of Appendix Neuroendocrine Tumors : A National Study from the French Group of Endocrine Tumors (GTE). Annals of Surgery, 2019, 270 (1), pp.165-171. ⟨10.1097/SLA.0000000000002736⟩. ⟨hal-02547901⟩
104 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More