Pancreatic neuroendocrine tumors: Surgical outcomes and survival analysis

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.