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

VJ Sallinen, TTY Le Large, E Tieftrunk, S Galeev, Z Kovalenko, SP Haugvik, A Antila, O Franklin, E Martinez-Moneo, SM Robinson, F Panzuto, N Regenet, F Muffatti, S Partelli, D Wiese, P Ruszniewski, B Dousset, B Edwin, DK Bartsch, A SauvanetM Falconi, GO Ceyhan, S Gaujoux, on the behalf of the Pancreas 2000 research group

Research output: Contribution to journalArticle

Abstract

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. © 2017 The Author(s).
Original languageEnglish
Pages (from-to)251-259
Number of pages9
JournalHPB
Volume20
Issue number3
DOIs
Publication statusPublished - 2018

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    Sallinen, VJ., Le Large, TTY., Tieftrunk, E., Galeev, S., Kovalenko, Z., Haugvik, SP., Antila, A., Franklin, O., Martinez-Moneo, E., Robinson, SM., Panzuto, F., Regenet, N., Muffatti, F., Partelli, S., Wiese, D., Ruszniewski, P., Dousset, B., Edwin, B., Bartsch, DK., ... group, O. T. B. O. T. P. . R. (2018). Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors - a multi-institutional study. HPB, 20(3), 251-259. https://doi.org/10.1016/j.hpb.2017.08.034