Prognosis of sporadic resected small (≤2 cm) nonfunctional pancreatic neuroendocrine tumors – a multi-institutional study. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Sallinen, Ville J.; Le Large, Tessa T.Y.; 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; Massimo, Falconi; Ceyhan, Güralp O.; Gaujoux, Sebastien
• Is Part Of: HPB. Volume 20:Issue 3(2018)
• Page Start: 251
• Page End: 259
• Publication Date: 2018-03
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2017.08.034
• Languages: English
• ISSNs: 1365-182X

Abstract

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.