HPB : the official journal of the International Hepato Pancreato Biliary Association · 2017
Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors - a multi-institutional study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Sallinen Ville J, Le Large Tessa Y S, Tieftrunk Elke, Galeev Shamil, Kovalenko Zahar, Haugvik Sven-Petter, Antila Anne, Franklin Oskar, Martinez-Moneo Emma, Robinson Stuart M, Panzuto Francesco, Regenet Nicolas, Muffatti Francesca, Partelli Stefano, Wiese Dominik, Ruszniewski Philippe, Dousset Bertrand, Edwin Bjørn, Bartsch Detlef K, Sauvanet Alain, Falconi Massimo, Ceyhan Güralp O, Gaujoux Sebastien, Pancreas 2000 research group
Аннотация
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.
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.
Предметные рубрики MeSH
AgedBile DuctsDatabases, FactualDilatation, PathologicDisease-Free SurvivalEuropeFemaleHumansMaleMiddle AgedNeoplasm GradingNeoplasm Recurrence, LocalNeuroendocrine TumorsPancreatectomyPancreatic DuctsPancreatic NeoplasmsPancreaticoduodenectomyRetrospective StudiesRisk FactorsTime FactorsTumor Burden