Surgical treatment of pNET – Experience of a "high-volume" center. (September 2018)

• Record Type: Journal Article
• Authors: Bösch, Florian; Hofmann, Katharina; Coenen, Michaela; Pratschke, Sebastian; Thomas, Michael; Knösel, Thomas; Bruns, Christiane J.; Guba, Markus; Werner, Jens; Angele, Martin K.
• Is Part Of: Surgical oncology. Volume 27:Number 3(2018)
• Page Start: 409
• Page End: 414
• Publication Date: 2018-09
• Subjects: Neuroendocrine tumor -- Pancreas -- Prognostic factor -- Multivisceral operation; 95% CI 95% confidence intervals -- ENETS European Neuroendocrine Tumor Society -- NET Neuroendocrine tumor -- pNET Neuroendocrine tumor of the pancreas -- UICC Union Internationale Contre le Cancer - International Union Against Cancer; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2018.05.027
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: Neuroendocrine tumors of the pancreas (pNETs) are a rare disease. Grading according to the Ki67-index is the most validated risk factor. Nevertheless, controversies exist concerning other prognostic factors. The aim of this study was to evaluate published risk factors. Methods: Patients with pancreatic NETs who underwent surgery at our department from 2000 to 2014 were analyzed. The patient and tumor characteristics were evaluated. Kaplan-Meier analyses, univariate calculations as well as multivariate analyses were performed. Results: In total, 98 patients underwent surgery due to a pNET. The final study population consisted of 88 patients. Univariate analysis demonstrated that overall survival is influenced by tumor grading, local resection margin and presence of distant metastases. However, in the multivariate analysis, only grading and the resection margin had prognostic significance. The size of the primary tumor directly correlated with the probability of metastases. Multivisceral operations had no influence on morbidity or mortality. Conclusions: Resection of pNETs is the only curative treatment and is safe. Since the incidence of pNETs is low, treatment should be performed at a high-volume center. Highlights: Modifying the grading system has no benefits in pancreatic neuroendocrine tumors. Tumor grading and local resection margins are prognostic relevant. Lymph node metastases or the lymph node ratio are prognostic not relevant. The extent of the primary tumor influences the probability of metastases. Multivisceral resections can be performed with a low morbidity.