TY - JOUR
T1 - Pancreatic neuroendocrine tumors
T2 - Surgical outcomes and survival analysis
AU - Fahmy, Joseph N.
AU - Varsanik, M. Alyssa
AU - Hubbs, Daniel
AU - Eguia, Emanuel
AU - Abood, Gerard
AU - Knab, Lawrence M.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Background: Pancreatic neuroendocrine tumors are rare, with rising incidence and limited clinicopathological studies. Methods: Adult patients with pNET at a single tertiary care center were retrospectively evaluated. Results: 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). Conclusions: 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.
AB - Background: Pancreatic neuroendocrine tumors are rare, with rising incidence and limited clinicopathological studies. Methods: Adult patients with pNET at a single tertiary care center were retrospectively evaluated. Results: 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). Conclusions: 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.
UR - http://www.scopus.com/inward/record.url?scp=85098486057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85098486057&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2020.12.037
DO - 10.1016/j.amjsurg.2020.12.037
M3 - Article
C2 - 33375953
AN - SCOPUS:85098486057
SN - 0002-9610
VL - 221
SP - 529
EP - 533
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -