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01-11-2019 | Pancreatectomy | Original Scientific Report

One-Year Postoperative Mortality in MEN1 Patients Operated on Gastric and Duodenopancreatic Neuroendocrine Tumors: An AFCE and GTE Cohort Study

Authors: Niki Christou, Muriel Mathonnet, Sébastien Gaujoux, Guillaume Cadiot, Sophie Deguelte, Jean-Louis Kraimps, Jean-Christophe Lifante, Fabrice Menegaux, Eric Mirallié, Fabrice Muscari, Bruno Carnaille, François Pattou, Alain Sauvanet, Pierre Goudet

Published in: World Journal of Surgery | Issue 11/2019

Abstract

Importance

In MEN1 patients with gastric and duodenopancreatic neuroendocrine tumors (GPD-NET), surgery aims to control secretions or to prevent metastatic spread, but after GPD-NET resection, postoperative mortality may be related to the surgery itself or to other associated MEN1 lesions with their own uncontrolled secretions or metastatic behavior.

Objective

To analyze the causes of death within 1 year following a GPD-NET resection in MEN1 patients.

Design

An observational study collecting data from the Groupe d’étude des Tumeurs Endocrines (GTE) database. The analysis considered the time between surgery and death (early deaths [<1 month after surgery] versus delayed deaths [beyond 1 month after surgery]) and the period (before 1990 vs after 1990). Causes of death were classified as related to GDP surgery, related to surgery for other MEN1 lesions or not related to MEN1 causes.

Setting

GTE database which includes 1220 MEN1 patients and 441 GPD-NET resections.

Participants

Four hundred and forty-one GPD-NET resections.

Main outcome measures

The primary end point was postoperative mortality within 1 year after surgery.

Results

Twenty-four patients met the inclusion criteria (2%). Median age at death was 50.5 years. Sixteen deaths occurred in the 30-day postoperative period (76%). Among the 8 delayed deaths, 3 occurred as a result of medical complications between 30 and 90 postoperative days. After 1990, mean age at death increased from 48 to 58 years (p = 0.09), deaths related to uncontrolled acid secretion disappeared (p < 0.001) and deaths related to associated MEN1 lesions increased from 8 to 54% (p = 0.16).

Conclusion

Surgery and uncontrolled secretions remain the two main causes of death in MEN1 patients operated for a GPD-NET tumor. Improving the prognosis of these patients requires a strict evaluation of the secretory syndrome and MEN1 aggressiveness before GDP surgery.

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Title: One-Year Postoperative Mortality in MEN1 Patients Operated on Gastric and Duodenopancreatic Neuroendocrine Tumors: An AFCE and GTE Cohort Study
Authors: Niki Christou
Muriel Mathonnet
Sébastien Gaujoux
Guillaume Cadiot
Sophie Deguelte
Jean-Louis Kraimps
Jean-Christophe Lifante
Fabrice Menegaux
Eric Mirallié
Fabrice Muscari
Bruno Carnaille
François Pattou
Alain Sauvanet
Pierre Goudet
Publication date: 01-11-2019
Publisher: Springer International Publishing
Keywords: Pancreatectomy
Insulinoma
Insulinoma
Neuroendocrine Tumor
Published in: World Journal of Surgery / Issue 11/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05107-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-Year Postoperative Mortality in MEN1 Patients Operated on Gastric and Duodenopancreatic Neuroendocrine Tumors: An AFCE and GTE Cohort Study

Abstract

Importance

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Importance

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

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