Sporadic non-functioning pancreatic neuroendocrine tumours: multicentre analysis

Area of Science:

• Oncology
• Surgical Gastroenterology
• Endocrinology

Background:

• Evaluating surgical outcomes for sporadic pancreatic neuroendocrine neoplasms (Pan-NENs).
• Assessing the impact of radical pancreatic resection on patient survival.
• Analyzing risk factors influencing mortality in Pan-NEN patients.

Purpose of the Study:

• To determine the relative survival (RS) rates after pancreatic resection for sporadic non-functioning Pan-NENs.
• To identify predictors of overall and disease-free survival.
• To evaluate the necessity and efficacy of surgical intervention based on tumor grade and stage.

Main Methods:

• Multicentre study of 964 patients undergoing radical pancreatic resection for sporadic non-functioning Pan-NENs.
• Survival analysis comparing patient mortality to the matched healthy Italian population.
• Calculation of relative survival (RS) and multivariable modeling to identify prognostic factors.

Main Results:

• Overall RS rate was 91.8%. 2019 WHO grade and ENETS TNM stage were independent predictors of RS.
• Disease-free RS rate was 73.6%. Both grade and stage significantly influenced disease-free RS.
• Probability of normal lifespan and disease-free survival varied significantly by tumor grade and stage, with Pan-NECs and G3 tumors having poor prognoses.

Conclusions:

• Surgery may not benefit pancreatic neuroendocrine carcinomas (Pan-NECs) and is unnecessary for small G1 sporadic Pan-NENs.
• Radical resection alone may be insufficient for advanced stage (III-IV) and high-grade (G3) Pan-NENs.
• Prognosis is strongly linked to tumor grade and stage, guiding treatment decisions.