Surgical Treatment as a Prognostic Factor for Survival in Patients with Neuroendocrine Tumors

Background: Surgical treatment is the only method that offers radical treatment in patients with neuro-endocrine tumors (NET). These tumors are commonly found later in their progression with bulky primary tumors with metastases. The slow growth of these tumours allows for aggressive surgical treatment, although up to 90% of NET patients develop metastases, and in 40% of them metastases are present at the moment of diagnosis.Aim: The aim of our study is to assess the prognostic factors influencing survival and quality of life in patients with NET. We established that such factors are: the presence of metastases, their resectability, as well as the type of surgical intervention. Materials and Methods: We performed a retrospective analysis of the characteristics of patients with NET subjected to surgical treatment in our Department for the period 1991 - 2015, as well as prospective analysis of their survival.Results: 98 patients with NET were included in our series: the mean survival time was 7.2 years with a median of 5.3 years. After a statistical analysis of the results, we established that the presence and number of liver metastases (p=0.025), as well as their resectability (N€<0.005) are significant prognostic factors regarding survival. In metastatic NET patients the survival period reaches 9.4 years after resection of the metastases.Major prognostic factor for survival of NET patients is the type of surgical intervention. In patients subjected to radical surgery (p=0.0001), the survival time was 9.037 years, and for the patients with palliative surgical procedures the survival is 0.737 years p=0.022. Discussion and Conclusions: The exact diagnosis, early discovery of the disease and the radical surgical procedure are the main parts of the surgical treatment of NET. The presence of regional or distant metastases significantly reduces the 5-year survival rate - 71% in patients without metastatic disease, compared to 38% in patients with metastases. Significant improvement in the survival length is achieved through aggressive surgical approach, even in the stage of advanced metastatic disease.