Long-term outcomes and prognostic factors in 78 Japanese patients with advanced pancreatic neuroendocrine neoplasms: a single-center retrospective study

Abstract Background: SYNTAX Score affects clinical outcomes in early studies, whether SYNTAX Score could predict long-term outcomes in patients with unstable angina pectoris (UAP) in the era of new generation drug-eluting stent was unclear, and differences by SYNTAX Score in long-term outcomes between the medical therapy and percutaneous coronary intervention (PCI) in UAP patients were not well known.Methods：In this single-center retrospective study, a total of 2,364 patients with UAP from January 2014 to June 2017 at Beijing Friendship Hospital were enrolled. The primary endpoint was a composite of major adverse cardiovascular events (MACE) , including all-cause death, cardiac death, nonfatal myocardial infarction (MI) and stroke after at least 2 year from discharge. Results：In this study, 1,695 patients had low SYNTAX score (<22) , 432 patients had medium SYNTAX score (22-32), and 237 patients had high SYNTAX score (≥33), and 1,018 received medical therapy, 1,346 patients underwent PCI. Long-term MACE occurred in 95 patients during 3.38 ± 0.99 years follow up. Cox multivariate regression analysis showed advanced age, diabetes mellitus, heart failure, chronic kidney disease (CKD) and high SYNTAX score were independent predictors for MACE in the medical therapy group (P < 0.05), while, heart failure and CKD were predictors of MACE in PCI group. Compared to medical therapy group, PCI group showed lower MACE and cardiac death in patients with high SYNTAX score (≥33) (7.4% vs. 16.7%, P = 0.048; 3.7% vs 14.6%, P = 0.004), but no reduction in patients with low- and medium SYNTAX score.Conclusions：High SYNTAX score could predict long-term MACE for UAP patients with medical therapy, but not for patients undergoing PCI. Compared to medical therapy, PCI could significantly reduced long-term MACE and cardiac death for patients with high SYNTAX score.

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Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

10.21203/rs.3.rs-27080/v2 ◽

2020 ◽

Author(s):

Ren-Chao Zhang ◽

Jun Ma ◽

yiping mou ◽

Yu-Cheng Zhou ◽

Wei-Wei Jin ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Neuroendocrine Neoplasms ◽

Transfusion Rate ◽

Long Term Outcomes ◽

Pancreatic Neuroendocrine Neoplasms ◽

Spleen Preserving ◽

Short And Long Term ◽

Organ Sparing

Abstract Background：Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasms associated with a long life expectancy after resection. In this setting, patients may benefit from laparoscopic organ-sparing resection. Studies of laparoscopic organ-sparing resection for PNENs are limited. The aim of this study was to evaluate the short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.Methods： A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses and morbidity, mortality, and follow-up data (until August 2018) were analysed.Results：Thirty-five patients were included in the final analysis. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3 kg/m2. Nine patients received laparoscopic enucleation (LE), 20 received laparoscopic spleen-preserving distal pancreatectomy (LSPDP), and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, and postoperative hospital stay were 186.4±60.2 min, 165±73.0 ml, 0 d, and 9 d (range, 5-23 d), respectively. The morbidity rate, grade ≥III complication rate and grade ≥B pancreatic fistula rate were 34.2%, 11.4%, and 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158 months). One patient developed recurrence 36 months after LE and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. One patient had diabetes after laparoscopic spleen-preserving distal pancreatectomy, and no patients had symptoms of pancreatic exocrine insufficiency. Conclusions： Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible and has favourable short- and long-term outcomes.

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