Surgical resection of the primary tumor improves survival in patients with pancreatic neuroendocrine tumors associated with liver metastases: a meta-analysis.

OBJECTIVE: The role of palliative pancreatic neuroendocrine tumor resection (pPanNEN-R) is controversial. The aim of this study was to conduct a meta-analysis of relevant studies to compare pPanNEN-R and non-surgical management (PanNEN-nR). METHODS: All studies published until May 31, 2024, comparing pPanNEN-R and PanNEN-nR were reviewed. The primary outcome was overall survival (OS). Meta-analysis was performed after the data extraction process. RESULTS: A total of 10 studies and 1152 patients were included, of whom 373 (32.38%) received pPanNEN-R, and 779 (67.62%) received PanNEN-nR. The overall quality of the included studies was fair. Patients receiving pPanNEN-R had a significantly lower risk of death compared with those receiving PanNEN-nR (odds ratio = 0.32, 95% confidence interval [0.24-0.43], p < 0.00001). CONCLUSIONS: The use of pPanNEN-R in patients with unresectable liver metastases seems to be associated with a better OS compared to non-surgical treatments, but due to the limitations of the included studies, no firm conclusions can be drawn.