Survival impact of primary tumor resesction among patients with nonresected liver metastases from gastrointestinal neuroendocrine carcinoma

The role of primary tumor resection (PTR) in the survival of gastrointestinal neuroendocrine carcinoma (GI-NEC) patients with liver-confined metastatic disease remains poorly defined. Analysis of such patients identified in the National Cancer Database found that PTR (23.1% of patients) was associated with improved overall survival as well before as after inverse probability of treatment weighting. This survival advantage persisted in an adjusted Cox model (IPTW adjusted HR 0.431; p<0.001). The improved OS persisted in subgroups stratified by primary tumor site, tumor grade, and N stage.