{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:48:35Z","timestamp":1783648115016,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Neuroendocrinology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    There are few, but controversial data on the prognostic role of upfront primary tumour resection and mesenteric lymph node dissection (PTR) in patients with diffuse metastatic small intestinal neuroendocrine neoplasia (SI\u2010NEN). Therefore, the prognostic role of PTR and other factors was determined in this setting. This retrospective cohort study included patients with stage IV SI\u2010NETs with unresectable distant metastases without clinical and radiological signs of acute bowel obstruction or ischaemia. Patients diagnosed from January 2002 to May 2020 were retrieved from a prospective SI\u2010NEN database. Disease specific overall survival (OS) was analysed with regard to upfront PTR and a variety of other clinical (e.g., gender, age, Hedinger disease, carcinoid syndrome, diarrhoea, laboratory parameters, metastatic liver burden, extrahepatic and extra\u2010abdominal metastasis) and pathological (e.g., grading, mesenteric gathering) parameters by uni\u2010 and multivariate analysis. A total of 138 patients (60 females, 43.5%) with a median age of 60\u00a0years, of whom 101 (73%) underwent PTR and 37 (27%) did not, were included in the analysis. Median OS was 106 (95% CI: 72.52\u2013139.48) months in the PTR group and 52 (95% CI: 30.55\u201373.46) in the non\u2010PTR group (\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.024), but the non\u2010PTR group had more advanced metastatic disease (metastatic liver burden \u226550% 32.4% vs. 13.9%). There was no significant difference between groups regarding the rate of surgery for bowel complications during a median follow\u2010up of 51\u00a0months (PTR group 10.9% and non\u2010PTR group 16.2%,\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.403). Multivariate analysis revealed age\u00a0&lt;\u00a060\u00a0years, normal C\u2010reactive protein (CRP) at baseline, absence of diarrhoea, less than 50% of metastatic liver burden, and treatment with PRRT as independent positive prognostic factors, whereas PTR showed a strong tendency towards better OS, but level of significance was missed (\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.067). However, patients who underwent both, PTR and peptide radioreceptor therapy (PRRT) had the best survival compared to the rest (137 vs. 73\u00a0months,\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.013). PTR in combination with PRRT significantly prolongs survival in patients with stage IV SI\u2010NEN. Prophylactic PTR does also not result in a lower reoperation rate compared to the non\u2010PTR approach regarding bowel complications.\n                  <\/jats:p>","DOI":"10.1111\/jne.13076","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T08:31:19Z","timestamp":1638952279000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Relevant prognostic factors in patients with stage IV small intestine neuroendocrine neoplasms"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3431-6233","authenticated-orcid":false,"given":"Elisabeth","family":"Maurer","sequence":"first","affiliation":[{"name":"Department of Visceral\u2010, Thoracic\u2010 and Vascular Surgery Philipps\u2010University Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Heinzel\u2010Gutenbrunner","sequence":"additional","affiliation":[{"name":"MH Statistik Beratung Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Rinke","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endocrinology Philipps\u2010University Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"R\u00fctz","sequence":"additional","affiliation":[{"name":"Department of Visceral\u2010, Thoracic\u2010 and Vascular Surgery Philipps\u2010University Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Holzer","sequence":"additional","affiliation":[{"name":"Department of Visceral\u2010, Thoracic\u2010 and Vascular Surgery Philipps\u2010University Marburg Marburg 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