Treatment of malignant pancreatic neuroendocrine neoplasms: middle-term (2-year) outcomes of a prospective observational multicentre study

Abstract

A radical resection is the cornerstone treatment of malignant pNENs and represents, together with Ki67 assessment, the most powerful prognostic factor for 2-year outcomes.

Chemotherapy for Well-Differentiated Pancreatic Neuroendocrine Tumours with a Ki-67 Index ≥10%: Is There a More Effective Antitumour Regimen? A Retrospective Multicentre Study of the French Group of Endocrine Tumours (GTE)

“…In line with this, other features also highlight the aggressiveness of the disease in our population: functioning tumours were rare (10%), 31% of the patients were classified as grade 3, and only 38% of the patients had previously undergone primary tumour surgery. Median OS is mainly influenced by primary tumour surgery, as previously reported [14,[40][41][42] .…”

Pancreaticoduodenectomy and metastasectomy for metastatic pancreatic neuroendocrine tumors

“…This is especially important for higher risk procedures, such as PD that carries substantial risk of morbidity and mortality . In regard to the resection of metastatic disease, some have advocated for aggressive surgical resection of metastatic sites to improve disease‐specific survival time Other published reports support a more conservative approach, endorsing metastasectomy within selected patient populations …”

Meta-analysis of Liver Resection Versus Nonsurgical Treatments for Pancreatic Neuroendocrine Tumors with Liver Metastases

“…It is well known that palliative resection has a limited contribution to the survival of patients with pNETs compared with radical resection. However, one of the included articles (Zerbi et al 2013) in this meta-analysis reported that Ki67 \5 or 10 % are independent predictors of 2-year overall and progression-free survival. 7 Furthermore, the 2-year prognosis of patients undergoing palliative resection was satisfactory in patients with \5 % Ki67% cells.…”

“…However, one of the included articles (Zerbi et al 2013) in this meta-analysis reported that Ki67 \5 or 10 % are independent predictors of 2-year overall and progression-free survival. 7 Furthermore, the 2-year prognosis of patients undergoing palliative resection was satisfactory in patients with \5 % Ki67% cells. If confirmed, palliative resection can be an option for selected patients after a preoperative assessment of disease grade.…”

“…2). [7][8][9][10][11][12][13] In these seven studies, the efficacy of liver resection versus nonsurgical regimens was investigated in the treatment of pNETs with liver metastases. In the pooled original studies, liver resection was significantly associated with a high rate of symptom relief (odds ratio There was statistically significant heterogeneity in the models for median survival time (Q = 57.598, P\0.001, I 2 = 96.528) and 2-or 3-year survival (Q = 8.402, P = 0.038, I 2 = 64.293).…”