Pancreatic neuroendocrine tumors: Surgical outcomes and survival analysis

Pancreatic neuroendocrine tumors are rare, with rising incidence and limited clinicopathological studies. Adult patients with pNET at a single tertiary care center were retrospectively evaluated. In total, 87 patients with histologically confirmed pNET who underwent resection were evaluated. 11% of...

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Bibliographic Details
Published in:The American journal of surgery 2021-03, Vol.221 (3), p.529-533
Main Authors: Fahmy, Joseph N., Varsanik, M. Alyssa, Hubbs, Daniel, Eguia, Emanuel, Abood, Gerard, Knab, Lawrence M.
Format: Article
Language:English
Subjects:
Adult
Aged
Complications
Demographics
Female
Humans
Insulinoma
Laparoscopy
Length of Stay
Lymph nodes
Lymphatic system
Male
Metastasis
Middle Aged
Minimally invasive
Minimally invasive surgery
Minimally Invasive Surgical Procedures
Morbidity
Neuroendocrine tumor
Neuroendocrine tumors
Neuroendocrine Tumors - mortality
Neuroendocrine Tumors - pathology
Neuroendocrine Tumors - surgery
Pancreas
Pancreatectomy
Pancreatic
Pancreatic cancer
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Pathology
pNET
Postoperative Complications - epidemiology
Retrospective Studies
Robotics
Splenectomy
Surgery
Surgical outcomes
Survival
Survival Analysis
Survival Rate
Treatment Outcome
Tumors
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Summary:Pancreatic neuroendocrine tumors are rare, with rising incidence and limited clinicopathological studies. Adult patients with pNET at a single tertiary care center were retrospectively evaluated. 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). 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. Survival for pancreatic neuroendocrine tumors is driven mostly by tumor grade. Minimally invasive surgery is a safe and effective approach to resecting these tumors.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.12.037