Major postoperative complications after pancreatic resection for P-NETS are not associated to earlier recurrence

Valente, Umberto; Lykoudis, Panagis M.; Tamburrino, Domenico; Inama, Marco; Passas, Ioannis; Toumpanakis, Christos; Luong, TuVinh; Davidson, Brian R; Imber, Charles; Malagó, Massimo; Rahman, Sunniyat; Shankar, Aparna; Sharma, Dheeraj; Caplin, Martyn; Fusai, Giuseppe

doi:10.1016/j.ejso.2017.07.012

Cited by 9 publications

(8 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The group of "well-differentiated" G1 and G2 pNENs is prognostically more advantageous than G3 tumors in the literature; in particular, G1 tumors have an excellent prognosis [22]. The differentiation between pNEN G1 and G2 after curative resection was already shown to be prognostically crucial for the occurrence of relapse in other studies [19,24]. This was confirmed in our cohort: no patient with a G1 tumor (n = 25) developed a tumor relapse.…”

Section: Discussionsupporting

confidence: 84%

See 1 more Smart Citation

Resection of Non-Functional Pancreatic Neuroendocrine Neoplasms—A Single-Center Retrospective Outcome Analysis

et al. 2021

View full text Add to dashboard Cite

Surgery remains the only curative treatment of pancreatic neuroendocrine neoplasms (pNEN). Here, we report the outcome after surgery for non-functional pNEN at a European Neuroendocrine Tumor Society (ENETS) center in Germany between 2000 and 2019; cases were analyzed for surgical (Clavien–Dindo classification; CDc) and oncological outcomes. Forty-nine patients (tumor grading G1 n = 25, G2 n = 22, G3 n = 2), with a median age of 56 years, were included. Severe complications (CDc ≥ grade 3b) occurred in 11 patients (22.4%) and type B/C pancreatic fistulas (POPFs) occurred in 5 patients (10.2%); in-hospital mortality was 2% (n = 1). Six of seven patients with tumor recurrence (14.3%) had G2 tumors in the pancreatic body/tail. The median survival was 5.7 years (68 months; [1–228 months]). Neither the occurrence (p = 0.683) nor the severity of complications had an influence on the relapse behavior (p = 0.086). This also applied for a POPF (≥B, p = 0.609). G2 pNEN patients (n = 22) with and without tumor recurrence had similar median tumor sizes (4 cm and 3.9 cm, respectively). Five of the six relapsed G2 patients (83.3%) had tumor-positive lymph nodes (N+); all G2 pNEN patients with recurrence had initially been treated with distal pancreatic resection. Pancreatic resections for pNEN are safe but associated with relevant postoperative morbidity. Future studies are needed to evaluate suitable resection strategies for G2 pNEN.

show abstract

Section: Discussionsupporting

confidence: 84%

“…One other study also focused on the impact of postoperative complications after resection of pNEN [19]. Interestingly, the rate of tumor recurrence was higher than in our study (28.5% versus 14.3%).…”

Section: Discussioncontrasting

confidence: 61%

Resection of Non-Functional Pancreatic Neuroendocrine Neoplasms—A Single-Center Retrospective Outcome Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The postoperative mortality of 2.7% was slightly lower than the 3.7% reported previously for an open approach ( 4 ). Except for the postoperative deaths, no significant association was found between surgical complications and overall survival, which is in line with a recent series of 105 surgically managed pancreatic neuroendocrine tumour patients ( 24 ). A recent study of 198 insulinoma patients, however, reported a higher reoperation rate after tumour enucleations compared to pancreatic resections ( 25 ).…”

Section: Discussionsupporting

confidence: 90%

Long-term morbidity and mortality in patients diagnosed with an insulinoma

Peltola

Hannula

Huhtala

et al. 2021

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Insulinomas are rare functional pancreatic neuroendocrine tumours. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the morbidity and mortality in the Finnish insulinoma cohort. Design: Retrospective cohort study Methods: Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980–2010 (n=79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs. 316 matched controls, using the Mantel-Haenszel method. Overall survival was analysed with Kaplan-Meier and Cox regression analyses. Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation [rate ratio, RR 2.07 (95% CI 1.02–4.22)], intestinal obstruction [18.65 (2.09–166.86)], and possibly breast [4.46 (1.29–15.39)] and kidney cancers (RR not applicable) was increased among insulinoma patients vs. controls, p<0.05 for all comparisons. Endocrine disorders and pancreatic diseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a non-metastatic insulinoma (n=70) was similar to that of controls, but for patients with distant metastases (n=9), the survival was significantly impaired (median 3.4 years). Conclusions: The long-term prognosis of patients with a non-metastatic insulinoma is similar to the general population, except for an increased incidence of atrial fibrillation, intestinal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.

show abstract

“…Atypical resections may have lesser long-term endocrine/exocrine sequelae, but there are risks of pancreatic fistulae (abnormal connections between pancreas and other organs/structures) [182]. Postoperative complications with pancreatic surgery do not appear to associate with the risk of recurrence of PanNEN [183].…”

Section: Surgical Intervention For Primary Tumours: Pannenmentioning

confidence: 99%

Neuroendocrine Neoplasms of the Small Bowel and Pancreas

et al. 2019

View full text Add to dashboard Cite

The traditionally promulgated perspectives of neuroendocrine neoplasms (NEN) as rare, indolent tumours are blunt and have been outdated for the last 2 decades. Clear increments in their incidence over the past decades render them increasingly clinically relevant, and at initial diagnosis many present with nodal and/or distant metastases (notably hepatic). The molecular pathogenesis of these tumours is increasingly yet incompletely understood. Those arising from the small bowel (SB) or pancreas typically occur sporadically; the latter may occur within the context of hereditary tumour predisposition syndromes. NENs can also be associated with endocrinopathy of hormonal hypersecretion. Tangible advances in the development of novel biomarkers, functional imaging modalities and therapy are especially applicable to this sub-set of tumours. The management of SB and pancreatic neuroendocrine tumours (NET) may be challenging, and often comprises a multidisciplinary approach wherein surgical, medical, interventional radiological and radiotherapeu-tic modalities are implemented. This review provides a comprehensive overview of the epidemiology, pathophysiology, diagnosis and treatment of SB and pancreatic NETs. Moreover, we provide an outlook of the future in these tumour types which will include the development of precision oncology frameworks for individualised therapy, multi-analyte predictive biomarkers, artificial intelligence-derived clinical decision support tools and elucidation of the role of the microbiome in NEN development and clinical behaviour.According to SEER version 18, SBNEN and PanNEN incidences are currently estimated at 1.2 and 0.7 per 100,000, respectively [5]. The overall 20-year duration prevalence of all NEN is estimated at 171,321; SBNEN constituting 32,122 patients with 3-fold fewer PanNEN (10,707) [5]. Possible attributable factors for this increase evolving epidemiology include increased use of endoscopy and also improvements in the sensitivity of widely used imaging modalities, leading to increased detection of early-stage, asymptomatic disease [5].The median overall survival (OS) for NEN (irrespective of site and grade) is 9.3 years [5]. For SB (median OS: 14 years), this ranges from 70 months (advanced disease with distant metastases) to 170 months (localised disease) and from 30 months (Grade 3) to 160 months (Grade 1). For pancreas (median OS: 3.6 years): 21 months (advanced) to 235 months (localised disease) and from 15 months (Grade 3) to 140 months (Grade 1) [5].Multivariable analyses have identified that ethnicity, age, differentiation, stage and site all have statistically significant correlations with survival. In general, Caucasian ethnicity, age (< 50 years) and localised, well-differentiated NEN exhibit the best survival. SB tumour patients are approximately 1.5 times more likely to survive longer than those with PanNEN [19]. Many of these correlations are self-evident since they pertain to degree of malignancy, disease duration and patient performance status.OS (median 5-year) app...

show abstract

Major postoperative complications after pancreatic resection for P-NETS are not associated to earlier recurrence

Cited by 9 publications

References 40 publications

Resection of Non-Functional Pancreatic Neuroendocrine Neoplasms—A Single-Center Retrospective Outcome Analysis

Resection of Non-Functional Pancreatic Neuroendocrine Neoplasms—A Single-Center Retrospective Outcome Analysis

Long-term morbidity and mortality in patients diagnosed with an insulinoma

Neuroendocrine Neoplasms of the Small Bowel and Pancreas

Contact Info

Product

Resources

About