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 language | English |
|---|---|
| Pages (from-to) | 18978-18983 |
| Number of pages | 6 |
| Journal | Oncotarget |
| Volume | 7 |
| Issue number | 14 |
| DOIs | |
| Publication status | Published - 2016 |
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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 journal › Article
}
TY - JOUR
T1 - A wait-and-watch approach to small pancreatic neuroendocrine tumors
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
Y1 - 2016
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.
KW - Neuroendocrine tumors
KW - Non-functional pancreatic neuroendocrine tumors
KW - Pancreatic neuroendocrine neoplasms
KW - PNEN
UR - http://www.scopus.com/inward/record.url?scp=84975504047&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84975504047&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.7902
DO - 10.18632/oncotarget.7902
M3 - Article
AN - SCOPUS:84975504047
VL - 7
SP - 18978
EP - 18983
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
IS - 14
ER -