Identifying Risk Factors and Patterns for Early Recurrence of Pancreatic Neuroendocrine Tumors: A Multi-Institutional Study

Background: Identifying patients at risk for early recurrence (ER) following resection for pancreatic neuroendocrine tumors (pNETs) might help to tailor adjuvant therapies and surveillance intensity in the post-operative setting. Methods: Patients undergoing surgical resection for pNETs between 1998...

Full description

Saved in:
Bibliographic Details
Published in:Cancers 2021-05, Vol.13 (9), p.2242
Main Authors: Heidsma, Charlotte M., Tsilimigras, Diamantis I., Rocha, Flavio, Abbott, Daniel E., Fields, Ryan, Poultsides, George A., Cho, Clifford S., Lopez-Aguiar, Alexandra G., Kanji, Zaheer, Fisher, Alexander V., Krasnick, Bradley A., Idrees, Kamran, Makris, Eleftherios, Beems, Megan, van Eijck, Casper H. J., Nieveen van Dijkum, Elisabeth J. M., Maithel, Shishir K., Pawlik, Timothy M.
Format: Article
Language:English
Subjects:
Abdomen
Cancer therapies
Chemotherapy
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Neuroendocrine tumors
Pancreas
Patients
Risk factors
Statistical analysis
Surgery
Surveillance
Survival
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Identifying patients at risk for early recurrence (ER) following resection for pancreatic neuroendocrine tumors (pNETs) might help to tailor adjuvant therapies and surveillance intensity in the post-operative setting. Methods: Patients undergoing surgical resection for pNETs between 1998–2018 were identified using a multi-institutional database. Using a minimum p-value approach, optimal cut-off value of recurrence-free survival (RFS) was determined based on the difference in post-recurrence survival (PRS). Risk factors for early recurrence were identified. Results: Among 807 patients who underwent curative-intent resection for pNETs, the optimal length of RFS to define ER was identified at 18 months (lowest p-value of 0.019). Median RFS was 11.0 months (95% 8.5–12.60) among ER patients (n = 49) versus 41.0 months (95% CI: 35.0–45.9) among non-ER patients (n = 77). Median PRS was worse among ER patients compared with non-ER patients (42.6 months vs. 81.5 months, p = 0.04). On multivariable analysis, tumor size (OR: 1.20, 95% CI: 1.05–1.37, p = 0.007) and positive lymph nodes (OR: 4.69, 95% CI: 1.41–15.58, p = 0.01) were independently associated with ER. Conclusion: An evidence-based cut-off value for ER after surgery for pNET was defined at 18 months. These data emphasized the importance of close follow-up in the first two years after surgery.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13092242