A wait-and-watch approach to small pancreatic neuroendocrine tumors: Prognosis and survival

Sara Massironi, Roberta Elisa Rossi, Alessandra Zilli, Giovanni Casazza, Clorinda Ciafardini, Dario Conte

Research output: Contribution to journalArticle

Abstract

Background: Whether all the small (φ≤20mm) non-functional pancreatic neuroendocrine neoplasms (pNENs) should be routinely resected is unclear. Aim: To assess the overall survival (OS) and progression-free survival (PFS) of patients with small pNENs, followed-up with different management options. Material and methods: Between 2007-2014, 51 patients were newly diagnosed with pNEN. 15 patients with pNENs φ ≤20 mm underwent an intensive follow-up at 3-month intervals during the first year and then every 6 months (FU pNEN group). They were all at TNM stage I, except for one patient at stage IIA. 21 patients underwent surgical resection (SR pNEN group): 2 patients were at TNM stage I, 9 IIA, one IIIB, 9 IV. 15 patients received systemic therapy (ST pNEN group) due to advanced disease or contraindications to surgery: 5 were at stage IIA, 2 IIB, 8 IV. Results: The median follow-up for the entire cohort was 50 months. Survival was similar in the FU and SR pNEN groups, but significantly worst in the ST pNEN patients (log-rank test P <0.05). The 4-year survival rate was 100% in the FU pNEN group, 90.5% among the SR pNEN patients, 61% for the ST pNEN ones (p <0.0001). The disease remained stable in all but one patient in the FU pNEN group, whereas six patients in the SR group and five in the ST group showed disease progression. Conclusions: The "wait-and-watch" approach to early-stage small pNENs appears to be safe although further studies are needed to confirm these results in larger cohorts of patients.

Original languageEnglish
Pages (from-to)18978-18983
Number of pages6
JournalOncotarget
Volume7
Issue number14
DOIs
Publication statusPublished - 2016

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Neuroendocrine Tumors
Pancreatic Neoplasms
Survival
Disease-Free Survival
Disease Progression

Keywords

  • Neuroendocrine tumors
  • Non-functional pancreatic neuroendocrine tumors
  • Pancreatic neuroendocrine neoplasms
  • PNEN

ASJC Scopus subject areas

  • Oncology

Cite this

A wait-and-watch approach to small pancreatic neuroendocrine tumors : Prognosis and survival. / Massironi, Sara; Rossi, Roberta Elisa; Zilli, Alessandra; Casazza, Giovanni; Ciafardini, Clorinda; Conte, Dario.

In: Oncotarget, Vol. 7, No. 14, 2016, p. 18978-18983.

Research output: Contribution to journalArticle

Massironi, S, Rossi, RE, Zilli, A, Casazza, G, Ciafardini, C & Conte, D 2016, 'A wait-and-watch approach to small pancreatic neuroendocrine tumors: Prognosis and survival', Oncotarget, vol. 7, no. 14, pp. 18978-18983. https://doi.org/10.18632/oncotarget.7902
Massironi, Sara ; Rossi, Roberta Elisa ; Zilli, Alessandra ; Casazza, Giovanni ; Ciafardini, Clorinda ; Conte, Dario. / A wait-and-watch approach to small pancreatic neuroendocrine tumors : Prognosis and survival. In: Oncotarget. 2016 ; Vol. 7, No. 14. pp. 18978-18983.
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abstract = "Background: Whether all the small (φ≤20mm) non-functional pancreatic neuroendocrine neoplasms (pNENs) should be routinely resected is unclear. Aim: To assess the overall survival (OS) and progression-free survival (PFS) of patients with small pNENs, followed-up with different management options. Material and methods: Between 2007-2014, 51 patients were newly diagnosed with pNEN. 15 patients with pNENs φ ≤20 mm underwent an intensive follow-up at 3-month intervals during the first year and then every 6 months (FU pNEN group). They were all at TNM stage I, except for one patient at stage IIA. 21 patients underwent surgical resection (SR pNEN group): 2 patients were at TNM stage I, 9 IIA, one IIIB, 9 IV. 15 patients received systemic therapy (ST pNEN group) due to advanced disease or contraindications to surgery: 5 were at stage IIA, 2 IIB, 8 IV. Results: The median follow-up for the entire cohort was 50 months. Survival was similar in the FU and SR pNEN groups, but significantly worst in the ST pNEN patients (log-rank test P <0.05). The 4-year survival rate was 100{\%} in the FU pNEN group, 90.5{\%} among the SR pNEN patients, 61{\%} for the ST pNEN ones (p <0.0001). The disease remained stable in all but one patient in the FU pNEN group, whereas six patients in the SR group and five in the ST group showed disease progression. Conclusions: The {"}wait-and-watch{"} approach to early-stage small pNENs appears to be safe although further studies are needed to confirm these results in larger cohorts of patients.",
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T2 - Prognosis and survival

AU - Massironi, Sara

AU - Rossi, Roberta Elisa

AU - Zilli, Alessandra

AU - Casazza, Giovanni

AU - Ciafardini, Clorinda

AU - Conte, Dario

PY - 2016

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N2 - Background: Whether all the small (φ≤20mm) non-functional pancreatic neuroendocrine neoplasms (pNENs) should be routinely resected is unclear. Aim: To assess the overall survival (OS) and progression-free survival (PFS) of patients with small pNENs, followed-up with different management options. Material and methods: Between 2007-2014, 51 patients were newly diagnosed with pNEN. 15 patients with pNENs φ ≤20 mm underwent an intensive follow-up at 3-month intervals during the first year and then every 6 months (FU pNEN group). They were all at TNM stage I, except for one patient at stage IIA. 21 patients underwent surgical resection (SR pNEN group): 2 patients were at TNM stage I, 9 IIA, one IIIB, 9 IV. 15 patients received systemic therapy (ST pNEN group) due to advanced disease or contraindications to surgery: 5 were at stage IIA, 2 IIB, 8 IV. Results: The median follow-up for the entire cohort was 50 months. Survival was similar in the FU and SR pNEN groups, but significantly worst in the ST pNEN patients (log-rank test P <0.05). The 4-year survival rate was 100% in the FU pNEN group, 90.5% among the SR pNEN patients, 61% for the ST pNEN ones (p <0.0001). The disease remained stable in all but one patient in the FU pNEN group, whereas six patients in the SR group and five in the ST group showed disease progression. Conclusions: The "wait-and-watch" approach to early-stage small pNENs appears to be safe although further studies are needed to confirm these results in larger cohorts of patients.

AB - Background: Whether all the small (φ≤20mm) non-functional pancreatic neuroendocrine neoplasms (pNENs) should be routinely resected is unclear. Aim: To assess the overall survival (OS) and progression-free survival (PFS) of patients with small pNENs, followed-up with different management options. Material and methods: Between 2007-2014, 51 patients were newly diagnosed with pNEN. 15 patients with pNENs φ ≤20 mm underwent an intensive follow-up at 3-month intervals during the first year and then every 6 months (FU pNEN group). They were all at TNM stage I, except for one patient at stage IIA. 21 patients underwent surgical resection (SR pNEN group): 2 patients were at TNM stage I, 9 IIA, one IIIB, 9 IV. 15 patients received systemic therapy (ST pNEN group) due to advanced disease or contraindications to surgery: 5 were at stage IIA, 2 IIB, 8 IV. Results: The median follow-up for the entire cohort was 50 months. Survival was similar in the FU and SR pNEN groups, but significantly worst in the ST pNEN patients (log-rank test P <0.05). The 4-year survival rate was 100% in the FU pNEN group, 90.5% among the SR pNEN patients, 61% for the ST pNEN ones (p <0.0001). The disease remained stable in all but one patient in the FU pNEN group, whereas six patients in the SR group and five in the ST group showed disease progression. Conclusions: The "wait-and-watch" approach to early-stage small pNENs appears to be safe although further studies are needed to confirm these results in larger cohorts of patients.

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