Prognostic and predictive factors on overall survival and surgical outcomes in pancreatic neuroendocrine tumors: recent advances and controversies

Expert Rev Anticancer Ther. 2019 Dec;19(12):1029-1050. doi: 10.1080/14737140.2019.1693893. Epub 2019 Nov 27.

Abstract

Introduction: Recent advances in diagnostic modalities and therapeutic agents have raised the importance of prognostic factors in predicting overall survival, as well as predictive factors for surgical outcomes, in tailoring therapeutic strategies of patients with pancreatic neuroendocrine neoplasms (panNENs).Areas covered: Numerous recent studies of panNEN patients report the prognostic values of a number of clinically related factors (clinical, laboratory, imaging, treatment-related factors), pathological factors (histological, classification, grading) and molecular factors on long-term survival. In addition, an increasing number of studies showed the usefulness of various factors, specifically biomarkers and molecular makers, in predicting recurrence and mortality related to surgical treatment. Recent findings (from the last 3 years) in each of these areas, as well as recent controversies, are reviewed.Expert commentary: The clinical importance of prognostic and predictive factors for panNENs is markedly increased for both overall outcome and post resection, as a result of recent advances in all aspects of the diagnosis, management and treatment of panNENs. Despite the proven prognostic utility of routinely used tumor grading/classification and staging systems, further studies are required to establish these novel prognostic factors to support their routine clinical use.

Keywords: Pancreatic neuroendocrine neoplasms; biomarker; molecular marker; pathological factor; prognostic factor; surgical resection.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Biomarkers, Tumor / metabolism*
  • Humans
  • Neoplasm Grading
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Prognosis
  • Survival Rate

Substances

  • Biomarkers, Tumor