TY - JOUR
T1 - Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors - a multi-institutional study
AU - Sallinen, Ville J.
AU - Le Large, Tessa Y.S.
AU - Tieftrunk, Elke
AU - Galeev, Shamil
AU - Kovalenko, Zahar
AU - Haugvik, Sven Petter
AU - Antila, Anne
AU - Franklin, Oskar
AU - Martinez-Moneo, Emma
AU - Robinson, Stuart M.
AU - Panzuto, Francesco
AU - Regenet, Nicolas
AU - Muffatti, Francesca
AU - Partelli, Stefano
AU - Wiese, Dominik
AU - Ruszniewski, Philippe
AU - Dousset, Bertrand
AU - Edwin, Bjørn
AU - Bartsch, Detlef K.
AU - Sauvanet, Alain
AU - Massimo, Falconi
AU - Ceyhan, Güralp O.
AU - Gaujoux, Sebastien
PY - 2018/3
Y1 - 2018/3
N2 - Background: Malignant potential of small (≤20 mm) nonfunctional pancreatic neuroendocrine tumors (sNF-PNET) is difficult to predict and management remain controversial. The aim of this study was to assess the prognosis of sporadic nonmetastatic sNF-PNETs. Methods: Patients were identified from databases of 16 centers. Outcomes and risk factors for recurrence were identified by uni- and multivariate analyses. Results: sNF-PNET was resected in 210 patients, and 66% (n = 138) were asymptomatic. Median age was 60 years, median tumor size was 15 mm, parenchyma-sparing surgery was performed in 42%. Postoperative mortality was 0.5% (n = 1), severe morbidity rate was 14.3% (n = 30), and 14 of 132 patients (10.6%) with harvested lymph nodes had metastatic lymph nodes. Tumor size, presence of biliary or pancreatic duct dilatation, and WHO grade 2-3 were independently associated with recurrence. Patients with tumors sized ≤10 mm were disease free at last follow-up. The 1-, 3- and 5-year disease-free survival rates for patients with tumors sized 11-20 mm on preoperative imaging were 95.1%, 91.0%, and 87.3%, respectively. Conclusions: In sNF-PNETs, the presence of biliary or pancreatic duct dilatation or WHO grade 2-3 advocate for surgical treatment. In the remaining patients, a wait-and-see policy might be considered.
AB - Background: Malignant potential of small (≤20 mm) nonfunctional pancreatic neuroendocrine tumors (sNF-PNET) is difficult to predict and management remain controversial. The aim of this study was to assess the prognosis of sporadic nonmetastatic sNF-PNETs. Methods: Patients were identified from databases of 16 centers. Outcomes and risk factors for recurrence were identified by uni- and multivariate analyses. Results: sNF-PNET was resected in 210 patients, and 66% (n = 138) were asymptomatic. Median age was 60 years, median tumor size was 15 mm, parenchyma-sparing surgery was performed in 42%. Postoperative mortality was 0.5% (n = 1), severe morbidity rate was 14.3% (n = 30), and 14 of 132 patients (10.6%) with harvested lymph nodes had metastatic lymph nodes. Tumor size, presence of biliary or pancreatic duct dilatation, and WHO grade 2-3 were independently associated with recurrence. Patients with tumors sized ≤10 mm were disease free at last follow-up. The 1-, 3- and 5-year disease-free survival rates for patients with tumors sized 11-20 mm on preoperative imaging were 95.1%, 91.0%, and 87.3%, respectively. Conclusions: In sNF-PNETs, the presence of biliary or pancreatic duct dilatation or WHO grade 2-3 advocate for surgical treatment. In the remaining patients, a wait-and-see policy might be considered.
UR - http://www.scopus.com/inward/record.url?scp=85030543692&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2017.08.034
DO - 10.1016/j.hpb.2017.08.034
M3 - Article
C2 - 28988702
AN - SCOPUS:85030543692
VL - 20
SP - 251
EP - 259
JO - HPB
JF - HPB
SN - 1477-2574
IS - 3
ER -