Pancreatic neuroendocrine tumors: Surgical outcomes and survival analysis

Am J Surg. 2021 Mar;221(3):529-533. doi: 10.1016/j.amjsurg.2020.12.037. Epub 2020 Dec 24.

Abstract

Background: Pancreatic neuroendocrine tumors are rare, with rising incidence and limited clinicopathological studies.

Methods: Adult patients with pNET at a single tertiary care center were retrospectively evaluated.

Results: In total, 87 patients with histologically confirmed pNET who underwent resection were evaluated. 11% of patients had functioning pNETs: 9 insulinoma and 1 VIPoma. The majority (88.5%) were nonfunctioning. The most common surgical procedure performed was distal pancreatectomy with splenectomy (36.8%). 35.6% of cases were performed with minimally invasive surgery (MIS). MIS patients had fewer postoperative complications, shorter length of stay, and fewer ICU admissions.Disease-free survival (DFS) was unaffected by tumor size (p = 0.5) or lymph node status (p = 0.62). Patients with high-grade (G3) tumors experienced significantly shorter DFS (p = 0.02).

Conclusions: This series demonstrates that survival in patients with pNET is driven mostly by tumor grade, though overall most have long-term survival after surgical resection. Additionally, an MIS approach is efficacious in appropriately selected cases.

Keywords: Insulinoma; Minimally invasive; Neuroendocrine tumor; Pancreatic; Survival; pNET.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Neuroendocrine Tumors / mortality*
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Pancreatectomy
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Splenectomy
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome