Pancreatic neuroendocrine tumours

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endocrinology

Background:

• Pancreatic neuroendocrine tumors (PNT) are rare neoplasms with a generally better prognosis than pancreatic adenocarcinoma.
• This study reviews a 22-year experience in managing PNT patients.

Purpose of the Study:

• To analyze surgical management strategies and outcomes for pancreatic neuroendocrine tumors.
• To identify factors influencing prognosis and complications in PNT patients.

Main Methods:

• Retrospective analysis of 49 patients with PNT over 22 years.
• Surgical procedures included enucleation, distal pancreatectomy, and other resections; some patients did not undergo resection.
• Tumor types included insulinomas, glucagonomas, gastrinomas, VIPomas, carcinoids, and nonfunctional tumors.

Main Results:

• A 22% postoperative complication rate was observed, with pancreatic fistulas being the most common.
• No mortality occurred; 94% of patients achieved symptomatic palliation.
• Actuarial mean survival was 163 months, with better outcomes for insulinomas, completely resected tumors, and benign histology.

Conclusions:

• Conservative pancreatic surgery is preferred, but aggressive resection is warranted for controllable primary tumors.
• Despite efforts to minimize resection, complications like pancreatic fistulas remain significant but are often manageable.
• Insulinomas and completely resected tumors demonstrate superior prognosis in PNT management.