Evidence map›Paper›PMID 42675351›Full record

ArticleAnnals of surgical oncology2026

Primary Resection and Metastasectomy for Well-Differentiated Grade 3 Gastro-Entero-Pancreatic Neuroendocrine Tumors: A National Cancer Database Analysis.

Thomas L Sutton, Marco Ventin, Teodora Dumitra, Shahrzad Arya, Lara Schwieger, Cristina R Ferrone, Andrew E Hendifar, Alexandra Gangi

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Thomas L Sutton *Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Marco Ventin *Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Teodora DumitraDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Shahrzad AryaDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Lara SchwiegerDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Cristina R FerroneDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Andrew E HendifarSamuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Alexandra GangiDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. alexandra.gangi@cshs.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with synchronous liver-metastatic low-grade (WHO grade 1/2) gastro-entero-pancreatic neuroendocrine tumors (GEPNETs), resection of primary and liver metastases is associated with improved overall survival (OS). The benefit of surgical resection in metastatic well-differentiated grade 3 GEPNETs, a recently defined tumor grade, remains unclear. We aimed to define survival benefit from primary resection and liver metastasectomy in patients with well-differentiated WHO grade (G) 3 GEPNETs.

methodsPatients diagnosed with well-differentiated WHO grade 1-3 synchronous liver-metastatic GEPNETs between 2018-2021 were identified from the National Cancer Database (NCDB). Kaplan-Meier and multivariable Cox proportional hazards modeling were utilized to evaluate the association of primary tumor and liver resection with OS.

resultsAmong 3,198 patients (G1: n=1434; G2: n=1113; G3: n=651), surgical intervention decreased with higher grade (G1: 67.3%; G2: 62.4%; G3: 31.3%, P<0.001). Ninety-day mortality was higher in G3 tumors (21.1%) compared with G1 (1.7%) and G2 (3.2%) (P<0.001), due to suspected early disease-related mortality. After a median follow-up of 35.5 months, median OS among G3 tumors was 8.1 months without surgery, 11.8 months with primary-only resection, and 24.4 months with liver and primary resection (combined liver/primary resection vs. no surgery: log-rank P=0.007), however survival curves converged over time with similar 3-year OS (25.7% vs. 19.3%). In contrast, G1-2 patients undergoing combined resection had improved 3-year OS (88.2% vs. 67.1%, P<0.001).

conclusionsPrimary and liver resection are associated with improved OS in G1-2 liver-metastatic GEPNETs. In G3 disease, surgical resection provides limited long-term survival benefit and should be considered selectively in a multidisciplinary setting.

Indexed as

Gastroenteropancreatic neuroendocrine tumorsGEPNETsLiver metastasesMetastasectomyNETsPancreatic neuroendocrine tumorSurgical resection

Identifiers

PMID42675351

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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.