Nonfunctioning, Small, Incidental Pancreatic Neuroendocrine Tumors: Results of a Nonoperative Approach Cohort

Galeano, Catalina Uribe; Prous, Joan Fabregat; Busquets, Juli; Serra, Núria; Medayo, Lluis Secanella; Rubio, Emilio Ramos; Osuna, Sandra Ruiz; Artero, Carlos Villabona

doi:10.1016/j.cireng.2016.12.003

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…A message to point out in these cases subjected to expectant conduct is related to the necessity of a strict monitoring of patients through imaging examination every 3 months during the first year of follow-up, followed by every 6 months during the next 3 years. Furthermore, upon any signs of tumor growth or malignancy, the treatment must be switched immediately to surgical resection [7,21]. However, small tumors can be malignant at presentation, as shown in this study, suggesting that surgical resection is still the best approach.…”

Section: Gastroenterology Research and Practicementioning

confidence: 91%

Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors

Figueira

Ribeiro

et al. 2021

Gastroenterology Research and Practice

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Background. The incidence of small nonfunctioning neuroendocrine pancreatic tumors (NF-PNETs) has been increasing systematically in the last few decades. Surgical resection was once considered the treatment of choice but has been questioned in the direction of a more conservative approach for selected patients. Our aim was to analyze the outcome of surgical resection of small (≤3cm) NF-PNETs. Methods. We retrospectively evaluated 14 patients with sporadic NF-PNETs who underwent pancreatic resection. Data were collected from patients’ medical records. Results. Of the 14 patients included, 35.71% were men, and the average age was 52.36 ± 20.36 years. Comorbidities were present in 92.86% of the cases. The incidence of postoperative complications was 42.86%, the 30-day mortality was zero, and the length of follow-up was 3.31 ± 3.0 years. The results of pathological evaluations revealed WHO grade I in 42.86% of cases, II in 21.43%, and neuroendocrine carcinoma in 35.71%. The median tumor size was 1.85cm (range, 0.5–3cm), and 2 cases had synchronous metastasis. The median TNM stage was IIa (range, I–IV). The disease-free and patient survival rates were 87.5% and 100% at 3 years and 43.75% and 75% at 10 years, respectively. The tumor pathological grade was significantly higher in head tumors than body-tail tumors, but there were no differences with respect to tumor size and TNM staging. Conclusion. A surgical approach to treat small sporadic NF-PNETs is safe with low mortality and high patient survival. Based on these data, small pancreatic head tumors can be more aggressive, suggesting that surgical resection is still the best option to treat small nonfunctioning PNETS. Thus, conservative treatment should be indicated very cautiously for only cases with absolute contraindications for surgery.

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Section: Gastroenterology Research and Practicementioning

confidence: 91%

Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors

Figueira

Ribeiro

et al. 2021

Gastroenterology Research and Practice

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“…5 Numerous studies since have shown that management of small PNET with imaging surveillance is safe, and does not result in worse with tumor-related survival. [21][22][23][24][25][26] Current PNET management guidelines from various societies recognize the role of nonoperative surveillance, however none incorporate age into the decision analysis. [27][28][29] Similar to PNET, there has been an increase in the detection of PCN.…”

mentioning

confidence: 99%

Age-related risks of complications after distal pancreatectomy for neuroendocrine and cystic neoplasms

Ramanathan

Abbas

Mason

et al. 2019

HPB

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Background: Distal pancreatic neuroendocrine tumors (PNET) and pancreatic cystic neoplasms (PCN) are often incidentally found in older adults, requiring careful consideration between operative management and watchful waiting. This study analyzes the short-term complications associated with distal pancreatectomy (DP) for PNET and PCN in older adults to inform clinical decision-making. Methods: Patients undergoing DP for PNET and PCN were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database and the pancreatectomy procedure-targeted dataset. Associations between decade of age and 30-day outcomes were evaluated.Results: 1626 patients were analyzed from 2014 to 2015. 692 (42.6%) were younger than 60 years, 507 (31.2%) were sexagenarians, 342 (21.0%) were septuagenarians, and 85 (5.2%) were octogenarians.Minimally invasive approaches were used in 62.7%. While septuagenarians and octogenarians constituted 26.3% of the cohort, they were affected by 55.6% of reintubations, 66.7% of failures to wean, 82.4% of myocardial infarctions, and 57.1% of septic shock. Septuagenarians and octogenarians had longer hospital stays, as compared to those younger than 60 years. Conclusion:Septuagenarians and octogenarians are disproportionately affected by perioperative complications after DP for PNET and PCN. Careful patient selection and thorough counseling should be provided when surgery is considered.

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Nonfunctioning, Small, Incidental Pancreatic Neuroendocrine Tumors: Results of a Nonoperative Approach Cohort

Cited by 2 publications

References 32 publications

Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors

Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors

Age-related risks of complications after distal pancreatectomy for neuroendocrine and cystic neoplasms

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