SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Is Resection of Primary Midgut Neuroendocrine Tumors in Patients with Unresectable Metastatic Liver Disease Justified? A Systematic Review and Meta-Analysis.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resection of the primary tumor with or without liver resection reduces the risk of death in patients with liver metastatic gastroenteropancreatic neuroendocrine tumors: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- [Gastroenteropancreatic neuroendocrine neoplasms-Heterogeneity, management and perspectives of treatment and research].Der Internist · 2020Pooled it
- Extended D3 Mesenterectomy in Small Bowel Cancer Treatment: Feasibility and Importance for Staging. First Results of a Prospective Clinical Trial.World journal of surgery · 2026Trial
- Primary Resection and Metastasectomy for Well-Differentiated Grade 3 Gastro-Entero-Pancreatic Neuroendocrine Tumors: A National Cancer Database Analysis.Annals of surgical oncology · 2026Article
- Surgery as a Principle and Technical Consideration for Primary Tumor Resection of Small Bowel Neuroendocrine Tumors.Annals of surgical oncology · 2024Review
- Surgical aspects of small intestinal neuroendocrine tumors.World journal of gastrointestinal surgery · 2023Review
- Review
- Survival of patients with small bowel neuroendocrine neoplasms in Auckland, Aotearoa New Zealand.ANZ journal of surgery · 2022Article
- The Role of Primary Tumor Resection in Patients With Pancreatic Neuroendocrine Tumors With Liver Metastases.Frontiers in oncology · 2022Article
- Surgical treatment for neuroendocrine liver metastasis: moving ahead in controversy.Hepatobiliary surgery and nutrition · 2021Article
- Resection of Primary Gastrointestinal Neuroendocrine Tumor Among Patients with Non-Resected Metastases Is Associated with Improved Survival: A SEER-Medicare Analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?Current oncology reports · 2021Review
- Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?Orphanet journal of rare diseases · 2021Article
- Role of Primary Tumor Resection for Metastatic Small Bowel Neuroendocrine Tumors.World journal of surgery · 2021Review
- A combination of surgery, theranostics, and liquid biopsy - a personalised oncologic approach to treatment of patients with advanced metastatic neuroendocrine neoplasms.International journal of medical sciences · 2021Article
- Clinical Features, Management, and Molecular Characteristics of Familial Small Bowel Neuroendocrine Tumors.Frontiers in endocrinology · 2021Review
- Surgical Principles in the Management of Small Bowel Neuroendocrine Tumors.Current treatment options in oncology · 2020Review
- Surgical management of pancreatic neuroendocrine liver metastases.Journal of gastrointestinal oncology · 2020Review
- Pancreatic neuroendocrine tumors: A review of serum biomarkers, staging, and management.World journal of gastroenterology · 2020Review
- Contemporary indications for and outcomes of hepatic resection for neuroendocrine liver metastases.World journal of gastrointestinal surgery · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with midgut neuroendocrine tumors (MNETs) frequently present with metastatic disease at the time of diagnosis. Although combined resection of the primary MNET and liver metastases (NELM) is usually recommended for appropriate surgical candidates, primary tumor resection (PTR) in the setting of extensive, inoperable metastatic disease remains controversial.
methodsA systematic review was performed according to PRISMA guidelines utilizing Medline (PubMed), Embase, and Cochrane library-Cochrane Central Register of Controlled Trials (CENTRAL) databases until September 30, 2018.
resultsAmong patients with MNET and NELM, 1226 (68.4%; range, 35.5-85.1% per study) underwent PTR, whereas 567 (31.6%; range, 14.9-64.5%) patients did not. Median follow-up ranged from 55 to 90 months. Cytoreductive liver surgery was performed in approximately 15.7% (range, 0-34.8%) of patients. Pooled 5-year overall survival (OS) among the resected group was approximately 73.1% (range, 57-81%) versus 36.6% (range, 21-46%) for the non-resection group. For patients without liver debulking surgery, PTR remained associated with a decreased risk of death at 5 years compared with patients who did not have the primary tumor resected (HR 0.36, 95% CI 0.16 to 0.79, p = 0.01; I
conclusionPTR was safe with a low peri-operative risk of mortality and was associated with an improved OS for patients with MNET and unresectable NELM. Given the poor quality of evidence, however, strong evidenced-based recommendations cannot be made based on these retrospective single center-derived data. Future well-design randomized controlled trials will be critical in elucidating the optimal treatment strategies for patients with MNET and advanced metastatic disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.