Surgery after sunitinib administration to improve survival of patients with advanced pancreatic neuroendocrine neoplasms

Abstract

Abstract Background Little research is available regarding the treatments combining surgical resection with systemic chemotherapy for advanced pancreatic neuroendocrine neoplasm patients. We retrospectively elucidated whether sunitinib administration before surgery in advanced pancreatic neuroendocrine neoplasm (Pan‐NEN) patients increases survival. Methods This study included 106 of 326 Pan‐NEN patients with distant metastases and/or unresectable locally advanced tumors who visited our department to receive sunitinib for more than 1 mo during April 2002 to December 2019. Risk factors for overall survival (OS) and disease‐free survival (DFS) were analyzed. Results The median duration of preoperative sunitinib administration and observation time after sunitinib were 6 and 26.5 mo, respectively. Of 106 patients, 31 (29.2%) underwent surgery following sunitinib administration. Hepatectomy, synchronous hepatopancreatectomy, pancreatectomy, and lymphadenectomy were performed for 13, 12, 5, and 1 patient, respectively. The 5‐y OS rates in the resected and nonresected groups were 88.9% and 14.1%, respectively (P 7.8% (HR, 7.4; P = .02) and R1 resection (HR, 4.4; P = .04). Conclusion Surgical resection after sunitinib administration improved OS in advanced Pan‐NENs.

Keywords

• neoadjuvant chemotherapy
• neuroendocrine neoplasms
• neuroendocrine tumors
• pancreatic tumor
• sunitinib