Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors - a multi-institutional study

Ville J. Sallinen*, Tessa Y.S. Le Large, Elke Tieftrunk, Shamil Galeev, Zahar Kovalenko, Sven Petter Haugvik, Anne Antila, Oskar Franklin, Emma Martinez-Moneo, Stuart M. Robinson, Francesco Panzuto, Nicolas Regenet, Francesca Muffatti, Stefano Partelli, Dominik Wiese, Philippe Ruszniewski, Bertrand Dousset, Bjørn Edwin, Detlef K. Bartsch, Alain SauvanetFalconi Massimo, Güralp O. Ceyhan, Sebastien Gaujoux

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Pages (from-to)251-259
Issue number3
Publication statusPublished - Mar 2018

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