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Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries

SIMPLE SUMMARY: No consensus has been reached regarding whether nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) ≤ 2 cm should be resected or observed. In this retrospective international multicenter study, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 i...

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Autores principales: Han, In Woong, Park, Jangho, Park, Eun Young, Yoon, So Jeong, Jin, Gang, Hwang, Dae Wook, Jiang, Kuirong, Kwon, Wooil, Xu, Xuefeng, Heo, Jin Seok, Fu, De-Liang, Lee, Woo Jung, Bai, Xueli, Yoon, Yoo-Seok, Yang, Yin-Mo, Ahn, Keun Soo, Yuan, Chunhui, Lee, Hyeon Kook, Sun, Bei, Park, Eun Kyu, Lee, Seung Eun, Kang, Sunghwa, Lou, Wenhui, Park, Sang-Jae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870171/
https://www.ncbi.nlm.nih.gov/pubmed/35205787
http://dx.doi.org/10.3390/cancers14041038
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author Han, In Woong
Park, Jangho
Park, Eun Young
Yoon, So Jeong
Jin, Gang
Hwang, Dae Wook
Jiang, Kuirong
Kwon, Wooil
Xu, Xuefeng
Heo, Jin Seok
Fu, De-Liang
Lee, Woo Jung
Bai, Xueli
Yoon, Yoo-Seok
Yang, Yin-Mo
Ahn, Keun Soo
Yuan, Chunhui
Lee, Hyeon Kook
Sun, Bei
Park, Eun Kyu
Lee, Seung Eun
Kang, Sunghwa
Lou, Wenhui
Park, Sang-Jae
author_facet Han, In Woong
Park, Jangho
Park, Eun Young
Yoon, So Jeong
Jin, Gang
Hwang, Dae Wook
Jiang, Kuirong
Kwon, Wooil
Xu, Xuefeng
Heo, Jin Seok
Fu, De-Liang
Lee, Woo Jung
Bai, Xueli
Yoon, Yoo-Seok
Yang, Yin-Mo
Ahn, Keun Soo
Yuan, Chunhui
Lee, Hyeon Kook
Sun, Bei
Park, Eun Kyu
Lee, Seung Eun
Kang, Sunghwa
Lou, Wenhui
Park, Sang-Jae
author_sort Han, In Woong
collection PubMed
description SIMPLE SUMMARY: No consensus has been reached regarding whether nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) ≤ 2 cm should be resected or observed. In this retrospective international multicenter study, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 institutions from 2000 to 2017 were enrolled and their medical records were reviewed. Tumor size > 1.5 cm, Ki-67 index ≥ 3%, and nodal metastasis were independent adverse prognostic factors for survival after multivariable analysis. NF-pNET patients with tumors ≤ 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs. ABSTRACT: Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors ≤ 2 cm do not necessarily need surgery. This study aims to establish a surgical treatment plan for NF-pNETs ≤ 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. The median age was 56 (range 16–80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (>1.5 cm; HR 4.28, 95% CI 1.80–10.18, p = 0.001) and nodal metastasis (HR 3.32, 95% CI 1.29–8.50, p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (HR 4.36, 95% CI 1.48–12.87, p = 0.008) and high Ki-67 index (≥3%; HR 9.06, 95% CI 3.01–27.30, p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs ≤ 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5 cm, Ki-67 index ≥ 3%, or nodal metastasis was present. NF-pNET patients with tumors ≤ 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs.
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spelling pubmed-88701712022-02-25 Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries Han, In Woong Park, Jangho Park, Eun Young Yoon, So Jeong Jin, Gang Hwang, Dae Wook Jiang, Kuirong Kwon, Wooil Xu, Xuefeng Heo, Jin Seok Fu, De-Liang Lee, Woo Jung Bai, Xueli Yoon, Yoo-Seok Yang, Yin-Mo Ahn, Keun Soo Yuan, Chunhui Lee, Hyeon Kook Sun, Bei Park, Eun Kyu Lee, Seung Eun Kang, Sunghwa Lou, Wenhui Park, Sang-Jae Cancers (Basel) Article SIMPLE SUMMARY: No consensus has been reached regarding whether nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) ≤ 2 cm should be resected or observed. In this retrospective international multicenter study, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 institutions from 2000 to 2017 were enrolled and their medical records were reviewed. Tumor size > 1.5 cm, Ki-67 index ≥ 3%, and nodal metastasis were independent adverse prognostic factors for survival after multivariable analysis. NF-pNET patients with tumors ≤ 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs. ABSTRACT: Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors ≤ 2 cm do not necessarily need surgery. This study aims to establish a surgical treatment plan for NF-pNETs ≤ 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. The median age was 56 (range 16–80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (>1.5 cm; HR 4.28, 95% CI 1.80–10.18, p = 0.001) and nodal metastasis (HR 3.32, 95% CI 1.29–8.50, p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (HR 4.36, 95% CI 1.48–12.87, p = 0.008) and high Ki-67 index (≥3%; HR 9.06, 95% CI 3.01–27.30, p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs ≤ 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5 cm, Ki-67 index ≥ 3%, or nodal metastasis was present. NF-pNET patients with tumors ≤ 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs. MDPI 2022-02-18 /pmc/articles/PMC8870171/ /pubmed/35205787 http://dx.doi.org/10.3390/cancers14041038 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Han, In Woong
Park, Jangho
Park, Eun Young
Yoon, So Jeong
Jin, Gang
Hwang, Dae Wook
Jiang, Kuirong
Kwon, Wooil
Xu, Xuefeng
Heo, Jin Seok
Fu, De-Liang
Lee, Woo Jung
Bai, Xueli
Yoon, Yoo-Seok
Yang, Yin-Mo
Ahn, Keun Soo
Yuan, Chunhui
Lee, Hyeon Kook
Sun, Bei
Park, Eun Kyu
Lee, Seung Eun
Kang, Sunghwa
Lou, Wenhui
Park, Sang-Jae
Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title_full Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title_fullStr Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title_full_unstemmed Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title_short Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
title_sort fate of surgical patients with small nonfunctioning pancreatic neuroendocrine tumors: an international study using multi-institutional registries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870171/
https://www.ncbi.nlm.nih.gov/pubmed/35205787
http://dx.doi.org/10.3390/cancers14041038
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