Primary tumor resection does not impact event-free survival in patients with metastatic small bowel neuroendocrine tumors

The study investigated the impact of primary tumor resection on the development of disease-specific complications in patients with metastatic well-differentiated small bowel neuroendocrine tumors (SBNETs). The retrospective analysis of 180 patients showed that rates of event-free survival did not differ based on primary tumor management. Patients who underwent medical management first had a 23% complication rate leading to surgery, compared to a 28% rate in surgically treated patients. The development of a primary tumor obstruction did not worsen outcomes, but ongoing tumor progression requiring a second surgery was associated with higher mortality.