Surgical Resection Provides an Overall Survival Benefit for Patients with Small Pancreatic Neuroendocrine Tumors

Abstract

Patients with localized PNETs ≤2 cm had an overall survival advantage with resection compared to observation, independent of age, comorbidities, tumor grade, and treatment with nonsurgical therapies.

Long‐Term Outcome of Laparoscopic Surgery for Pancreatic Neuroendocrine Tumors

“…The study demonstrated that surgery and chemotherapy of nonmetastatic disease improved survival, despite recurrent disease after a median of 7 months postoperatively, compared with chemotherapy alone (median survival 23 versus 13 months). In a recent comparable study, patients with nonmetastatic PNEC ≤ 2 cm who underwent resection, had a median survival of 29 months, while patients who were left to best supportive care had a median survival of 5 months (versus 2 months in our study) 217 . The three-year survival from time of metastasis after resection of nonmetastatic PNEC in our study was surprisingly high (45%).…”

“…This is supported by recent reports of the effect of surgery on survival for PNENs across all stages of disease, including PNECs49,109 . Since work began on this thesis, a novel interest in surgical treatment of PNEC has been noted26,217,218 , although the underlying clinical evidence for a surgical approach is still scarce and prospective trials are lacking. There is a need for raised awareness of this evolving field in pancreatic surgery.…”

Non-functioning pancreatic neuroendocrine tumors: Surgery or observation?

“…Contrary to this claim, Sharpe et al[60] performed a population based study and demonstrated that patients who were managed with observation had nearly three times the risk of mortality in comparison to those who underwent resection[60]. Their study was large and based on patients collected from NCDB, all with NF-PNETs smaller than 2 cm.…”

Pancreatic neuroendocrine tumors: the basics, the gray zone, and the target

“…The 5-year OS was 82.2% for patients who underwent surgery and 34.3% for those who were observed ( p <0.0001). Patients with localized PanNETs ≤2 cm had an overall advantage with resection compared to observation, a fact that was found to be independent of age, comorbidities, tumor grade, and treatment with non-surgical therapies 51 .…”