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• W4244876906 abstract "Background: Non-functional pancreatic neuroendocrine tumors (NF-PNET) are rare tumors increasingly being diagnosed incidentally. Choice of treatment for small (2cm or less) NF-PNETs is difficult as their malignant potential is difficult to predict. This is reflected in the current recommendations - some favor surgery, while others suggest wait-and-see policy.[1–6] As these tumors are rare, previous clinical series are small. The aim of this study was to identify factors affecting prognosis after surgery for small NF-PNETs in a multicenter study. Methods: Patients were identified from the databases of 16 European centers and data was extracted retrospectively. Uni- and multivariate (Cox) analyses were used to identify risk factors for recurrence. Results: 210 patients (median age 60y) were included. Median tumor size was 15mm, 65% were asymptomatic, and 42% underwent parenchyma-sparing surgery. Severe mordibidity was noted in 14% and 1 patient died postoperatively. 10% had metastatic lymph nodes. 5-year disease-free survival was excellent, 93.5%. Tumor size, presence of bile or pancreatic duct dilation, and WHO grade 2 -3 were identified as independent risk factors for recurrence. Tumors <11mm in size did not recur during follow-up. Parenchyma-sparing pancreatectomy carried highest risk for pancreatic fistula, but was also associated with favorable disease-free survival. Conclusion: Presence of bile or pancreatic duct dilation or WHO grade 2-3 advocate for surgical treatment of small (2cm or less) NF-PNETs. References [1] Lee, (2012), Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): Role for nonoperative management., Surgery. [2] Gaujoux, (2013), Observational Study of Natural History of Small Sporadic Nonfunctioning Pancreatic Neuroendocrine Tumors., The Journal of Clinical Endocrinology & Metabolism. [3] Sallinen, (2015), Outcomes of resected nonfunctional pancreatic neuroendocrine tumors: Do size and symptoms matter?, Surgery. [4] Haynes, (2011), Implications of incidentally discovered, nonfunctioning pancreatic endocrine tumors: short-term and long-term patient outcomes., Arch Surg. [5] Gratian, (2014), Impact of Extent of Surgery on Survival in Patients with Small Nonfunctional Pancreatic Neuroendocrine Tumors in the United States., Ann Surg Oncol. [6] Sharpe, (2014), Surgical Resection Provides an Overall Survival Benefit for Patients with Small Pancreatic Neuroendocrine Tumors, J Gastrointest Surg." @default.
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• W4244876906 date "2019-01-01" @default.
• W4244876906 modified "2023-09-30" @default.
• W4244876906 title "Prognosis of sporadic resected small (≤ 2 cm) nonfunctional pancreatic neuroendocrine tumors – A multi-institutional study" @default.
• W4244876906 doi "https://doi.org/10.1016/j.hpb.2019.10.1426" @default.
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