{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:47:09Z","timestamp":1789577229502,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100015459","name":"Danish Cancer Society Research Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015459","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Neuroendocrinology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The benefit of surgery in high\u2010grade gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) and mixed neuroendocrine\u2010non\u2010neuroendocrine neoplasms (MiNEN) is uncertain. The present study aimed to investigate outcomes after tumour surgery in patients with high\u2010grade (Ki\u201067 &gt;\u00a020%) GEP NEN or MiNEN stage I\u2010III or stage IV. We analysed data from patients treated in the period 2007\u20102015 at eight Nordic university hospitals. Overall survival (OS) and progression\u2010free survival (PFS)\/disease\u2010free survival (DFS) were analysed by Kaplan\u2010Meier estimates. Prognostic factors were evaluated using Cox regression. We included 201 surgically resected patients, 143 stage I\u2010III and 58 stage IV, with 68% having neuroendocrine carcinoma, 23% MiNEN, 5% neuroendocrine tumour G3 and 4% uncertain NEN G3. Primary tumours were located in colon\/rectum (52%), oesophagus\/cardia (19%), pancreas (10%), stomach (7%), jejunum\/ileum (5%), duodenum (4%), gallbladder (2%) and anal canal (1%). For patients with stage I\u2010III, median DFS was 12\u00a0months (95% confidence interval [CI]\u00a0=\u00a05.5\u201018.5) and median OS was 32\u00a0months (95% CI\u00a0=\u00a024.0\u201040.0). For patients with stage I\u2010III and an R0 resection, median DFS was 21\u00a0months (95% CI\u00a0=\u00a04.9\u201037.1) and median OS was 39\u00a0months (95% CI\u00a0=\u00a025.0\u201053.0). For patients with stage IV, median PFS\/DFS was 4\u00a0months (95% CI\u00a0=\u00a01.9\u20106.1) and median OS was 11\u00a0months (95% CI\u00a0=\u00a04.8\u201017.2). For patients with stage IV and an R0 resection, median DFS was 6\u00a0months (95% CI\u00a0=\u00a00\u201016.4) and median OS was 32\u00a0months (95% CI\u00a0=\u00a025.5\u201038.5). Performance status &gt;\u00a01 and colorectal primary were associated with poor prognosis. There was no difference in survival between patients with high\u2010grade GEP NEN and MiNEN. Surgery of the primary tumour in patients with loco\u2010regional high\u2010grade GEP NEN or MiNEN led to good long\u2010term results and should be considered if an R0 resection is considered achievable. Highly selected patients with stage IV disease may also benefit from surgery.<\/jats:p>","DOI":"10.1111\/jne.12967","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T08:24:17Z","timestamp":1616747057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Surgery of the primary tumour in 201 patients with high\u2010grade gastroenteropancreatic neuroendocrine and mixed neuroendocrine\u2010non\u2010neuroendocrine neoplasms"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7068-1946","authenticated-orcid":false,"given":"Hans\u2010Christian","family":"Pommergaard","sequence":"first","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Surgery and Transplantation Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstine","family":"Nielsen","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Surgery and Transplantation Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Endocrinology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halfdan","family":"Sorbye","sequence":"additional","affiliation":[{"name":"Department of Oncology Haukeland University Hospital  Bergen Norway"},{"name":"Department of Clinical Science University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte","family":"Federspiel","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Pathology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizaveta M.","family":"Tabaksblat","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Oncology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene W.","family":"Vestermark","sequence":"additional","affiliation":[{"name":"Department of Oncology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva T.","family":"Janson","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Uppsala University Hospital  Uppsala Sweden"},{"name":"Department of Medical Sciences Endocrine Oncology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten P.","family":"Hansen","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Surgery and Transplantation Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Ladekarl","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Oncology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Oncology Clinical Cancer Research Center Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herish","family":"Garresori","sequence":"additional","affiliation":[{"name":"Department of Oncology Stavanger University Hospital  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir O.","family":"Hjortland","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Oslo University Hospital  Oslo Norway"},{"name":"Department of Oncology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sundl\u00f6v","sequence":"additional","affiliation":[{"name":"Department of Oncology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Galleberg","sequence":"additional","affiliation":[{"name":"Department of Oncology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Knigge","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Endocrinology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Physiology Nuclear Medicine &amp; PET and Cluster for Molecular Imaging University of Copenhagen and Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kjaer","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Physiology Nuclear Medicine &amp; PET and Cluster for Molecular Imaging University of Copenhagen and Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo W.","family":"Langer","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Oncology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Knigge","sequence":"additional","affiliation":[{"name":"ENETS Neuroendocrine Tumor Centre of Excellence Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Surgery and Transplantation Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Endocrinology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,26]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"WHO Classification of Tumours Editorial Board. 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