Überlebensraten von Patienten mit chirurgisch resezierten neuroendokrinen Neoplasien des Ileums

Neuroendokrine Neoplasien des Ileums sind seltene submuköse Tumoren. Sie werden häufig in fortgeschrittenen Stadien mit metastatischem Befall der Leber diagnostiziert, wodurch die chirurgischen Möglichkeiten oft begrenzt sind. Die spärliche Datenlage limitiert den heutigen Wissenstand bezüglich des...

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Bibliographic Details
Main Author: Schuchmann, Martha
Contributors: Fendrich, Volker (Prof. Dr.) (Thesis advisor)
Format: Dissertation
Published: Philipps-Universität Marburg 2016
Online Access:PDF Full Text
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Table of Contents: Neuroendocrine neoplasias (NENs) of the jejunoileum are often diagnosed at advanced stages with metastatic spread to the liver so that surgery is limited in most patients. Data on survival is scarce and not much is known about factors influencing survival. Data from all patients who underwent surgery for a neuroendocrine neoplasia of the ileum between 2000 and 2014 were retrieved from a prospective database. For each patient, gender, age at surgery, comorbidity, TNM-Classification, Ki67%, symptoms, lymph node and liver metastasis, lymph node ratio, surgical procedure performed, localization of the primary, blood group and preoperative CRP were recorded. Furthermore we followed patients after primary surgery until last follow up or death. 125 patients were included in the present study. After a median follow up of 48 months (range 1-157) 71 patients (56,8%) were still alive (Group I), 47 patients (37.6%) had already died (Group II) and 7 patients (5.6%) were lost to follow up. A certain lymph node ratio was associated with significantly decreased survival. Patients still alive had a mean lymph node ratio of 0.158, whereas patients who died had a lymph node ratio of 0.488 (p=0.000). Between Group I and II there were statistically significant differences concerning tumor localization, surgical procedure, somatostatin receptor status and symptoms at diagnosis. Localized and regionally restricted metastasized ileojejunal NENs have an excellent prognosis after surgical treatment. An increased Lymph node ratio above 0.5% is a new prognostic factor in NENs of the ileum and radical lymphadenectomy should be performed.