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The clinicopathologic and operative characteristics of patients with small nonfunctioning pancreatic neuroendocrine tumors

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Abstract
Background: Incidentally detected, small nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) are increasingly diagnosed on imaging modalities. This retrospective investigation evaluated the clinicopathologic characteristics and perioperative and oncologic outcomes in patients with small NF-PNETs undergoing curative resection.

Methods: The medical records of 444 patients who underwent pancreatic resection for NF-PNETs at a single, large-volume institution between January 2000 and December 2018 were retrospectively reviewed. Patients were divided into those with small (=2 cm) and large (>2 cm) tumors based on the largest tumor diameter on preoperative computed tomography (CT). Outcomes were also evaluated in subgroups of patients with small NF-PNET who did and did not undergo lymphadenectomy.

Results: Of the 444 patients with NF-PNETs, 195 (43.9%) had small (=2 cm) and 249 (56.1%) had large (>2 cm) NF-PNETs. The rate of parenchyma-preserving surgery (14.4% vs. 7.2%, p = 0.014) and the ratio of spleen preservation for left-sided pancreatectomy (65.6% vs. 38.3%, p < 0.001) were higher in the small NF-PNET group. Size on CT >2 cm (p < 0.001, hazard ratio [HR]: 5.836, 95% confidence interval [CI]: 2.474-13.769), presence of perineural invasion (p < 0.001, HR: 3.025, 95% CI: 1.640-5.577), World Health Organization (WHO) Grade 2 (p = 0.007, HR: 2.861, 95% CI: 1.325-6.176), and WHO Grade 3 (p < 0.001, HR: 11.537, 95% CI: 5.282-25.199) were independent predictors of disease-free survival (DFS). DFS did not differ significantly in patients with small NFPNETs who did and did not undergo lymphadenectomy (p = 0.886).

Conclusions: Assessment of long-term oncologic outcomes suggests that surgical resection may cure small NF-PNETs. Minimally invasive surgery and organ-preserving surgery are acceptable treatment options for select patients with small NF-PNETs. The effect on survival outcomes of lymph node dissection for small NF-PNETs remains unclear.
Author(s)
권재우김송철박예종송기병신다겸이우형이재훈전은성하수현홍사랑황대욱
Issued Date
2021
Type
Article
Keyword
disease‐free survivalMedical recordsMedical researchMedicineExperimentalminimally invasive surgical proceduresnonfunctioning pancreatic endocrine tumorpancreatectomyretrospective studiesTumorsWorld health
DOI
10.1111/ans.17055
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8550
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2554352316&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,The%20clinicopathologic%20and%20operative%20characteristics%20of%20patients%20with%20small%20nonfunctioning%20pancreatic%20neuroendocrine%20tumors&amp;offset=0&amp;pcAvailability=true
Publisher
ANZ JOURNAL OF SURGERY
Location
영국
Language
영어
ISSN
1445-1433
Citation Volume
91
Citation Number
7
Citation Start Page
484
Citation End Page
492
Appears in Collections:
Medicine > Medicine
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