Neuroendocrine Tumours of the Pancreas: Predictors of Survival after Surgical Treatment

Jarufe, Nicolás; Coldham, C.; Oruğ, Taner; Mayer, Amit; Mirza, D.; Buckels, J.; Bramhall, Simon R.

doi:10.1159/000087148

Cited by 61 publications

(51 citation statements)

References 63 publications

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“…Surgical margin status is another significant indicator for long-term survival. Some studies have also concluded that aggressive resection of WD-Ca and PD-Ca can improve long-term survival [26,27,28]. Chung et al [30], Phan et al [31], and Madeira et al [32] reported surgical margin is a prognostic related factor, which also support the aggressive resection.…”

Section: Discussionmentioning

confidence: 96%

Surgical Treatment of Pancreatic Neuroendocrine Tumors: Report of 112 Cases

Gao

Pan

et al. 2010

Dig Surg

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Objectives: To review the clinical data of a group of patients with pancreatic neuroendocrine tumors (pNETs) and to investigate the role of surgery in the treatment for pNETs by analyzing clinical manifestations and postoperative course of this rare disease. Methods: A total of 112 patients (aged 21–76 years; 45 males) who underwent treatment between 1980 and 2003 were recruited in this study. Patients’ data related to demographics and characteristics, diagnostic studies, surgical and tumor characteristics and survival were retrospectively reviewed. Results: Forty-six patients (41.1%) had a well-differentiated neuroendocrine tumor (WDT), 44 (48.2%) a well-differentiated neuroendocrine carcinoma (WD-Ca) and 12 (10.7%) a poorly differentiated neuroendocrine carcinoma (PD-Ca). Nonfunctional tumors were seen in 65 (58.0%) patients, whereas functional tumors were found in 47 (42.0%) patients, including 26 insulinomas, 17 gastrinomas, 2 VIPomas, 1 glucagonoma, and 1 ACTHoma. The sensitivity of computed tomography was 87.1%. Surgical resection was performed in 99 (88.4%) patients. Thirty-eight (33.9%) patients underwent partial pancreaticoduodenectomy, 32 (28.6%) had distal pancreatectomy and 29 (25.9%) underwent enucleation. No surgery-related death occurred. The common postoperative complications were pancreatic fistula (15.2%), wound infection (13.4%) and delayed gastric emptying (6.3%). Three (5%) patients had reoperation due to intra-abdominal abscess and postoperative hemorrhage. Twenty-six (55.3%) of the 47 functional tumors were malignant, whereas 40 (61.5%) of the 65 nonfunctional tumors were malignant. Survival was significantly related to the type of neuroendocrine tumor (p = 0.001). The overall 5-year actual survival rate of patients with WD-Ca (n = 54) was 56%, significantly less than that of patients with WDT (n = 46, 91%, p = 0.001). All the patients of PD-Ca (n = 12) group died in 5 years. The 5-year survival rate differed significantly between patients with tumor node metastasis (TNM) stage I and II disease and those with stage III and IV tumors (p = 0.011). Patients with stage III had better prognosis than those with stage IV tumors (p = 0.007). Patients’ long-term survival was closely correlated with vascular invasion (p = 0.008) and resection margin (p = 0.004). Conclusions: PNETs can be safely resected. Microscopic vascular invasion and positive resection margin are helpful for predicting patient survival. Malignant cases should be treated with aggressive radical surgery to achieve complete tumor resection and potential for long-term survival.

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Section: Discussionmentioning

confidence: 96%

Surgical Treatment of Pancreatic Neuroendocrine Tumors: Report of 112 Cases

Gao

Pan

et al. 2010

Dig Surg

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“…These tumors are symptomatic in 15% to 53% of the cases due to secretion of biologically active substances. The remaining are nonfunctioning and usually asymptomatic, although 50% are malignant and require surgical resection (6,13) . The literature reports 13 cases of accessory spleen simulating pancreatic tumors, all of them submitted to surgical resection (7,15,25) .…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Ardengh¹,

Lopes

Kemp

et al. 2013

Arq. Gastroenterol.

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-Context -Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective -To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic nodules suspicious for pancreatic splenosis. Method -From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results -A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6%) cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7), young (mean age: 42 years) and asymptomatic (8). Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion -Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules.

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“…Tumor grade and distant metastasis are the most important prognostic factors in determining survival in ANET. Other tumor properties, like nodal involvement, tumor size and resection margins, appear to be of lesser significance in predicting long-term survival [18]- [20].…”

Section: Survival and Long-term Follow Upmentioning

confidence: 99%

Ampullary Neuroendocrine Tumor: A Rare Cause of Recurrent Abdominal Pain

Ofosu¹,

Taccone²,

Potakamuri³

2014

CRCM

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Ampullary Neuroendocrine tumor (ANET) is a rare GI malignancy, representing less than 1% of GI neuroendocrine tumors and less than 2% of ampullary tumors. Traditional treatment is often a pancreaticoduodenectomy; however, local and endoscopic resections have been successful. We report a rare case of ANET in a 21-year-old Burmese man who presented with a 6-year history of non-specific intermittent abdominal pain who was successfully managed through transduodenal ampullectomy. At 24 months postoperatively he remains disease and symptom free. ANET is a rare cause of recurrent abdominal pain, and local excision of small ANETs can be an alternative, less morbid treatment for young patients. We follow the case with a brief review of the literature.

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Neuroendocrine Tumours of the Pancreas: Predictors of Survival after Surgical Treatment

Cited by 61 publications

References 63 publications

Surgical Treatment of Pancreatic Neuroendocrine Tumors: Report of 112 Cases

Surgical Treatment of Pancreatic Neuroendocrine Tumors: Report of 112 Cases

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Ampullary Neuroendocrine Tumor: A Rare Cause of Recurrent Abdominal Pain

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