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Surgical Treatment of Neuroendocrine Tumors of the Terminal Ileum or Cecum: Ileocecectomy Versus Right Hemicolectomy

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Simple ileocecectomy and right hemicolectomy are two potential operative approaches to treat patients with neuroendocrine neoplasm in the terminal ileum and/or cecum (IC-NENs). We sought to define the long-term outcome of patients undergoing ileocecectomy versus right hemicolectomy for IC-NENs, as well as characterize number of nodes evaluated and lymph node metastasis (LNM) associated with each procedure.

Methods

Patients who underwent curative-intent resections for IC-NENs between 2000 and 2016 were identified from a multi-institutional database. The clinicopathologic characteristics, surgical procedures, and the overall (OS) and recurrence-free survival (RFS) were compared among patients who underwent formal right hemicolectomy versus ileocecectomy only.

Results

Among 127 patients with IC-NENs, median size of the largest tumor size was 2.0 (IQR 1.2–2.9) cm; 35 (27.6%) patients had multiple lesions. At the time of surgery, 93 (73.2%) patients underwent a right hemicolectomy, whereas 34 (26.8%) had ileocecectomy only. Every patient had a lymph node dissection (LND) with a median number of 16 (IQR 12–22) nodes evaluated. A majority (n = 110, 86.6%) of patients had LNM with a median number of 3 (IQR 2–5) LNM. Patients who underwent hemicolectomy had more lymph nodes evaluated versus patients who had an ileocecectomy only (median, 18 vs. 14, p = 0.004). Patients who underwent formal right hemicolectomy versus ileocecectomy had a similar OS (median OS, 101.9 vs. 144.5 months, p = 0.44) and RFS (median RFS, 70.3 vs. not attained, p = 0.80), respectively.

Conclusions

Ileocecectomy had similar long-term outcomes versus right hemicolectomy in treatment of IC-NENs despite a difference in the lymph node harvest.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, China

    Mu-Xing Li & Xu-Feng Zhang

  2. Department of General Surgery, Peking University Third Hospital, Beijing, China

    Mu-Xing Li

  3. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA

    Alexandra G. Lopez-Aguiar & Shishir K. Maithel

  4. Department of Surgery, Stanford University, Palo Alto, CA, USA

    George Poultsides

  5. Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA

    Flavio Rocha

  6. Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Sharon Weber

  7. Department of Surgery, Washington University School of Medicine, St. Louis, WI, USA

    Ryan Fields

  8. Division of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, TN, USA

    Kamran Idrees

  9. Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA

    Cliff Cho

  10. Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA

    Xu-Feng Zhang & Timothy M. Pawlik

Authors
  1. Mu-Xing Li
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  2. Alexandra G. Lopez-Aguiar
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  3. George Poultsides
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  4. Flavio Rocha
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  5. Sharon Weber
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  6. Ryan Fields
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  8. Cliff Cho
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  10. Xu-Feng Zhang
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Corresponding authors

Correspondence to Xu-Feng Zhang or Timothy M. Pawlik.

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Li, MX., Lopez-Aguiar, A.G., Poultsides, G. et al. Surgical Treatment of Neuroendocrine Tumors of the Terminal Ileum or Cecum: Ileocecectomy Versus Right Hemicolectomy. J Gastrointest Surg 26, 1266–1274 (2022). https://doi.org/10.1007/s11605-022-05269-1

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  • DOI: https://doi.org/10.1007/s11605-022-05269-1

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