Resection versus expectant management of small incidentally discovered nonfunctional pancreatic neuroendocrine tumors

• Published in: Surgery 2016, Vol.159 (1), p.302-310
• Main Authors: Rosenberg, Alex M., BA, Friedmann, Patricia, MS, Del Rivero, Jaydira, MD, Libutti, Steven K., MD, Laird, Amanda M., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Disease Progression; Female; Humans; Incidental Findings; Male; Middle Aged; Neuroendocrine Tumors - mortality; Neuroendocrine Tumors - pathology; Neuroendocrine Tumors - therapy; Pancreatectomy; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - therapy; Patient Selection; Prognosis; Retrospective Studies; Surgery; Watchful Waiting
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2015.10.013

Background Sporadic, nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are diagnosed with increasing frequency. We compared the risk of tumor growth, metastasis, and mortality between patients treated versus those treated expectantly. Method A retrospective study of patients seen at our institution with sporadic NF-PNETs, with ≥12 months of follow-up. Kaplan-Meier analysis was performed. Results Between 1999 and 2014, 35 patients with an incidentally discovered nonfunctional PNET were identified. Twenty underwent resection and 15 were followed with imaging. In the operative group, 8 had NF-PNETs < 2 cm, while 12 had NF-PNETs ≥ 2 cm. In the nonoperative expectant management by serial imaging group, 10 had NF-PNETs < 2 cm while 5 had NF-PNETs ≥ 2 cm. Small NF-PNETs (