The Need for Centralization for Small Intestinal Neuroendocrine Tumor Surgery: A Cohort Study from the GTE-Endocan-RENATEN Network, the CentralChirSINET Study
In: ISSN: 1068-9265, 2023
Online
academicJournal
Zugriff:
International audience ; BackgroundThe concept of surgical centralization is becoming more and more accepted for specific surgical procedures.ObjectiveThe aim of this study was to evaluate the relationship between procedure volume and the outcomes of surgical small intestine (SI) neuroendocrine tumor (NET) resections.MethodsWe conducted a retrospective national study that included patients who underwent SI-NET resection between 2019 and 2021. A high-volume center (hvC) was defined as a center that performed more than five SI-NET resections per year. The quality of the surgical resections was evaluated between hvCs and low-volume centers (lvCs) by comparing the number of resected lymph nodes (LNs) as the primary endpoint.ResultsA total of 157 patients underwent surgery in 33 centers: 90 patients in four hvCs and 67 patients in 29 lvCs. Laparotomy was more often performed in hvCs (85.6% vs. 59.7%; p < 0.001), as was right hemicolectomy (64.4% vs. 38.8%; p < 0.001), whereas limited ileocolic resection was performed in 18% of patients in lvCs versus none in hvCs. A bi-digital palpation of the entire SI length (95.6% vs. 34.3%, p < 0.001), a cholecystectomy (93.3% vs. 14.9%; p < 0.001), and a mesenteric mass resection (70% vs. 35.8%; p < 0.001) were more often performed in hvCs. The proportion of patients with ≥8 LNs resected was significantly higher (96.3% vs. 65.1%; p < 0.001) in hvCs compared with lvCs, as was the proportion of patients with ≥12 LNs resected (87.8% vs. 52.4%). Furthermore, the number of patients with multiple SI-NETs was higher in the hvC group compared with the lvC group (43.3% vs. 25.4%), as were the number of tumors in those patients (median of 7 vs. 2; p < 0.001).ConclusionsOptimal SI-NET resection was significantly more often performed in hvCs. Centralization of surgical care of SI-NETs is recommended.
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The Need for Centralization for Small Intestinal Neuroendocrine Tumor Surgery: A Cohort Study from the GTE-Endocan-RENATEN Network, the CentralChirSINET Study
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Autor/in / Beteiligte Person: | Kalifi, Maroin ; Deguelte, Sophie ; Faron, Matthieu ; Afchain, Pauline ; de Mestier, Louis ; Lecomte, Thierry ; Pasquer, Arnaud ; Subtil, Fabien ; Alghamdi, Khalid ; Poncet, Gilles ; Walter, Thomas ; Hospices Civils de Lyon (HCL) ; Hôpital Robert Debré ; Hôpital Robert Debré-Hôpital universitaire Robert Debré Reims (CHU Reims) ; Oncostat (U1018 (Équipe 2)) ; Institut Gustave Roussy (IGR)-Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay ; Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay ; CHU Saint-Antoine AP-HP ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) ; Hôpital Beaujon AP-HP ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) ; Université Paris Cité (UPCité) ; Niche, Nutrition, Cancer et métabolisme oxydatif (N2Cox) ; Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL) ; Centre Léon Bérard Lyon -Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) ; King Abdulaziz University ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon ; Hôpital Edouard Herriot CHU -, HCL |
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Zeitschrift: | ISSN: 1068-9265, 2023 |
Veröffentlichung: | HAL CCSD ; Springer Verlag, 2023 |
Medientyp: | academicJournal |
DOI: | 10.1245/s10434-023-14276-8 |
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