The effect of using long-acting octreotide as adjuvant therapy for patients with grade 2 pancreatic neuroendocrine tumors after radical resection

摘要

Objective:To investigate the effect of long-acting octreotide as adjuvant therapy in the prevention of tumor recurrence in patients with grade 2 pancreatic neuroendocrine tumors(pNETs)after radical resection.Methods:The postoperative follow-up data of 130 patients with resectable G2 pNET treated in the Changhai Hospital from 2008 to 2018 were retrospectively analyzed:59 patients received long-acting octreotide as adjuvant therapy for 6 to 12 months(Oct group)and 71 patients received active follow-up(control group),both of which began after the radical resection,with the primary observation endpoint of disease-free survival(DFS)and the secondary study endpoint of overall survival.Results:The median age of the patients in the Oct group and control group was 52 and 54 years,respectively.There were 28 male cases(47.5%)and 33 male cases(46.5%)in the 2 groups.The median maximum tumor diameter was 3.5 and 3.0 cm,respectively;lymph node metastasis was positive in 13 cases(22.0%)and 9 cases(12.7%);there was peripancreatic nerve invasion in 11 cases(18.6%)and 6 cases(8.5%).Survival analysis revealed that there were significant differences in 2-year DFS%(98.3%vs 88.7%,P=.0371)and 3-year DFS%(96.6%vs 85.9%,P=.0498)between the Oct group and control group.Long-acting octreotide treatment was found to reduce the risk of 3-year recurrence of G2 pNET after radical resection(HR=0.2,P=.044)with the application of inverse-probability-of-treatment weighted to balance the limited data bias.Conclusion:Using long-acting octreotide as adjuvant therapy for G2 pNET patients after radical surgery may improve the rate of 3y-DFS,but the benefit needs to be confirmed in a well-designed random control clinical trial.