Circulating Chromogranin A Is Associated With Disease Extent, Progression, and Recurrence in Patients With Nonfunctioning Pancreatic Neuroendocrine Tumor.

OBJECTIVES: Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) are rare tumors with heterogeneous biology. Radiology and serum biomarkers are used for postresection surveillance; however, no universally established protocol exists. Serum chromogranin A (CgA) concentration is elevated in NF-PNET and generally correlates with burden of disease; many CgA studies include mixed gastrointestinal and pancreatic populations. We sought to review the NF-PNET literature with focus on postresection surveillance and hypothesized that CgA is useful for surveillance after NF-PNET resection.

MATERIALS AND METHODS: Comprehensive English literature review by PICO criteria (P, human NF-PNET patients; I, pancreatectomy; C, none; O, CgA correlation with disease recurrence).

RESULTS: Four studies yielded granular data for resected NF-PNET patients. From 333 patients, 113 recurred and 110 (97%) had elevated CgA. Additional 7 studies with mixed gastro-entero-pancreatic NET included 269 NF-PNET patients. In these patients, CgA uniformly predicted disease extent.

CONCLUSIONS: Serum CgA correlates with disease extent in NF-PNET and is useful for surveillance after resection of NF-PNET.