TY - JOUR
T1 - The size of well differentiated pancreatic neuroendocrine tumors correlates with Ki67 proliferative index and is not associated with age
AU - Partelli, Stefano
AU - Muffatti, Francesca
AU - Rancoita, Paola Maria Vittoria
AU - Andreasi, Valentina
AU - Balzano, Gianpaolo
AU - Crippa, Stefano
AU - Doglioni, Claudio
AU - Rubini, Corrado
AU - Zamboni, Giuseppe
AU - Falconi, Massimo
PY - 2019/5
Y1 - 2019/5
N2 - Background: Concerns exist about a conservative management of well-differentiated nonfunctioning small pancreatic neuroendocrine tumors (NF-PanNET) in young patients and when preoperative Ki67 proliferative index is ≥3%. Aim: To evaluate an association between age, tumor size and grading in patients with sporadic NF-PanNET who underwent curative resection. Methods: Patients who underwent surgery for sporadic NF-PanNET (excluding G3) were retrospectively analyzed. Linear regression analysis was performed to evaluate a possible correlation between continuous variables, whereas multiple logistic regression analysis was performed for determining predictors of NF-PanNET-G2. Results: Overall, 235 patients with NF-PanNET-G1/G2 were included. The median largest radiological diameter was 25 mm. Age correlated neither with tumor size (P = 0.675) nor with Ki67 index (P = 0.376). On multivariate linear regression analysis, factors independently associated with Ki67 index were NF-PanNET size (P = 0.031), perineural invasion (P = 0.004), microvascular invasion (P = 0.001) and necrosis (P = 0.009). The most accurate NF-PanNET size for predicting NF-PanNET-G2 was 25 mm. On multivariate analysis, a NF-PanNET size >25 mm was independently associated with the risk of having a PanNET-G2 (P = 0.025). Conclusion: No correlations exist between age and NF-PanNET size or proliferative index. Therefore, an a priori aggressive attitude is not justified in young patients with small NF-PanNET, as a long-life expectancy is probably unlikely to increase the risk of malignant transformation.
AB - Background: Concerns exist about a conservative management of well-differentiated nonfunctioning small pancreatic neuroendocrine tumors (NF-PanNET) in young patients and when preoperative Ki67 proliferative index is ≥3%. Aim: To evaluate an association between age, tumor size and grading in patients with sporadic NF-PanNET who underwent curative resection. Methods: Patients who underwent surgery for sporadic NF-PanNET (excluding G3) were retrospectively analyzed. Linear regression analysis was performed to evaluate a possible correlation between continuous variables, whereas multiple logistic regression analysis was performed for determining predictors of NF-PanNET-G2. Results: Overall, 235 patients with NF-PanNET-G1/G2 were included. The median largest radiological diameter was 25 mm. Age correlated neither with tumor size (P = 0.675) nor with Ki67 index (P = 0.376). On multivariate linear regression analysis, factors independently associated with Ki67 index were NF-PanNET size (P = 0.031), perineural invasion (P = 0.004), microvascular invasion (P = 0.001) and necrosis (P = 0.009). The most accurate NF-PanNET size for predicting NF-PanNET-G2 was 25 mm. On multivariate analysis, a NF-PanNET size >25 mm was independently associated with the risk of having a PanNET-G2 (P = 0.025). Conclusion: No correlations exist between age and NF-PanNET size or proliferative index. Therefore, an a priori aggressive attitude is not justified in young patients with small NF-PanNET, as a long-life expectancy is probably unlikely to increase the risk of malignant transformation.
KW - Grading
KW - Pancreatic neuroendocrine neoplasms
KW - Tumor size
UR - http://www.scopus.com/inward/record.url?scp=85060865065&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060865065&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2019.01.008
DO - 10.1016/j.dld.2019.01.008
M3 - Article
C2 - 30723019
AN - SCOPUS:85060865065
VL - 51
SP - 735
EP - 740
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 5
ER -