Resection of Metastatic Pancreatic Neuroendocrine Tumors After Induction System Treatment

Study Overview
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Brief Summary
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This study is to evaluate the efficacy and tolerability of surgery in selecting patients who can benefit from the synchronous resection of primary pancreatic neuroendocrine tumor and liver metastasis after induction systemic treatment. The willing of participants decide who receive surgery and who will continue to receive standard systemic treatment.

Detailed Description
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system treatments of metastatic PanNET include SSA, sunitinib, mTOR inhibitor and chemotherapy. For patients achieved PR/SD after system treatment, resection of primary tumor and metastasis maybe a better way to decline tumor burden and get longer survival. this real world study is focused on this group of patients with metastatic PanNET, and to evaluate the efficacy and tolerability of surgery in selecting patients who can benefit from the synchronous resection of primary pancreatic neuroendocrine tumor and liver metastasis after induction systemic treatment.

Official Title
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Resection of Metastatic Pancreatic Neuroendocrine Tumors After Induction System Treatment: Real World Study

Conditions
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Neuroendocrine Tumors, Metastases, Surgery

Intervention / Treatment
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* Procedure: system treatment and surgery
* Other: system treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Biopsy-proven neuroendocrine tumor primary site in pancreas Advanced disease with lymph node or distant metastases (N1, M1) cannot undergoing cytoreduction by surgery/local ablative therapy at the diagnosis curative intent of all therapies possible ECOG 0-2 Exclusion Criteria: Undifferentiated neuroendocrine carcinoma or mixed neuroendocrine carcinoma secondary tumor functioning NET or advanced carcinoid heart disease part of hereditary syndrome, such as MEN1, VHL do not willing to receive systemic treatment diagnosed with other cancer within 5 years

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| system treatment<br>Patients continue to receive standard system treatment, including SSA, targeted therapy and chemotherapy. | Other: system treatment<br>* to patients with PR/SD after system treatment, investigator assess the tumor is resectable, and participants decide to continue take system treatment.<br>|
| system treatment and Surgery<br>Patients receive synchronous resection of primary tumor and metastasis after system treatment. and treatment after surgery is based on the clinical decision. | Procedure: system treatment and surgery<br>* to patients with PR/SD after system treatment, investigator assess the tumor is resectable, and participants decide to receive Synchronous resection of primary tumor and metastasis. after surgery, the investigator decide further treatments.<br>* Other names: resection of primary and metastatic tumors;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| progression-free survival |  | 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| overall survival |  | 5 years | 
| Number of Postoperative morbidity | Including pancreatic fistula, biliary fistula, hemorrhage, wound infection, delayed gastric emptying, reoperation | Up to 90 days after operation | 
| number of Postoperative mortality |  | Up to 90 days after operation |