Clinicopathological Characteristics and Prognosis-Related Factors of Resectable Pancreatic Neuroendocrine Tumors

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

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Clinicopathological characteristics of non-functioning cystic pancreatic neuroendocrine tumors

Pancreatology ◽

10.1016/j.pan.2018.11.010 ◽

2019 ◽

Vol 19 (1) ◽

pp. 50-56 ◽

Cited By ~ 9

Author(s):

Yohei Nakashima ◽

Takao Ohtsuka ◽

So Nakamura ◽

Yasuhisa Mori ◽

Kohei Nakata ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Clinicopathological Characteristics ◽

Pancreatic Neuroendocrine Tumors

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The management of small asymptomatic pancreatic neuroendocrine tumors: A matched case-control study.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.239 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 239-239

Author(s):

Eran Sadot ◽

Diane Lauren Reidy ◽

Laura H. Tang ◽

Mithat Gonen ◽

Michael Ian D'Angelica ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Tumor Size ◽

Operative Management ◽

Clinicopathological Characteristics ◽

Low Grade ◽

Pancreatic Neuroendocrine Tumors ◽

Resection Group ◽

Imaging Characteristics ◽

Initial Imaging

239 Background: Overdiagnosis and overtreatment has become an evolving challenge for several cancer sub-types. We hypothesized that a substantial portion of incidentally diagnosed small pancreatic neuroendocrine tumors(PanNET) are overtreated as a result of overdiagnosis and that non-operative management may be reasonable for selected patients. Methods: Consecutive patients evaluated for incidentally discovered, sporadic, stage I-II PanNET were analyzed retrospectively. Diagnosis was determined either by pathology or unequivocal imaging characteristics. Patients selected for radiographic surveillance (RS) were matched with patients who underwent resection based on tumor size at initial imaging. Clinicopathological characteristics were compared between the groups. Results: During the study period (2000-2013), RS was recommended for 80 patients, and 79 matched patients underwent resection (resection group). Pathologic diagnosis was obtained in 42 (53%) of the 80 RS patients. Median initial tumor size was similar between the RS vs resection groups (1.2cm (0.8-1.7) vs 1.3 cm (1-1.9), respectively, p=0.4). The resection group was younger and had a longer median follow-up compared to the RS group (58 vs 65 years, p<0.001; 50 vs 29 months, p=0.006; respectively). At the time of last follow-up of the RS group, median tumor size had not changed (1.2cm, p=0.4), no patient had developed metastases, and no patient had experienced radiographic changes in the primary tumor that prompted resection. Within the resection group, low-grade (G1) pathology was recorded in 74 (95%) tumors, one patient had node positive disease, and five developed recurrence (6%). The postoperative complication rate was 36%. No patient in either group died from disease. Death from other causes occurred in 7 out of 159(4%) patients. Conclusions: In this study, no patient who was selected for observation developed metastases or died from disease after a median follow-up of almost 2.5 years.Radiographic surveillance for stable, small, incidentally discovered PanNETs is reasonable in selected patients.

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