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Management and outcomes of patients for non-functioning pancreatic neuroendocrine tumours: a multi-institutional
Bingqing Du1, Xing Wang2, Wangfa Zhang3
1Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Background:
To analysed the short- and long-term outcomes of patients who underwent surgical resection for non-functioning pancreatic neuroendocrine tumours (NF-PNETs) to gain insights into treatment approaches for this rare and heterogeneous entity.
Methods:
All patients who underwent surgical resection for NF-PNETs at The Second Affiliated Hospital of Guangzhou Medical University, and West China Hospital, Sichuan University, from 2009 to 2019 were retrospectively reviewed. The data of patients was including perioperative management, pathologic analysis and follow-up.
Results:
A total of 119 cases with histologically or cytologically confirmed NF-PNETs, The mean age of the patients was 52, and 56.3% were female. Twenty-three patients received post-operative adjuvant therapy, and five of nine (55.6%) patients with distant metastasis showed recurrence 14(60.9%) G2/G3 patients without distant metastasis received post-operative therapy with octreotide. Of these 14 patients, 3 (21.4%) revealed recurrence. Univariate analysis indicated that symptoms (P = 0.03), tumour size >4 cm (P = 0.029), ENETS stages III-IV (P < 0.001), positive lymph nodes (P < 0.001), vascular/perineural invasion (P < 0.001), and pathology grade G2 were associated with significantly higher risks of recurrence; age, gender, surgery type, and tumour location were not. Multivariate analysis revealed that positive lymph nodes (P < 0.001), vascular/peripheral invasion (P < 0.001), and pathology grade G3 (P = 0.03) are significant prognostic factors of tumour recurrence.
Conclusion:
Positive lymph nodes, vascular/peripheral invasion and pathology grade G3 were related to recurrence of NF-PNETs. Lymph node resection is recommend when FNA biopsy indicates pathology grade G3 for patients with NF-PNETs.
Insights
Positive lymph nodes, vascular invasion, and high-grade pathology (G3) are key predictors of recurrence in non-functioning pancreatic neuroendocrine tumors (NF-PNETs) after surgery. Lymph node resection is advised for G3 NF-PNETs identified via FNA biopsy.
Area of Science:
- Oncology
- Surgical Pathology
- Gastroenterology
Background:
- Non-functioning pancreatic neuroendocrine tumors (NF-PNETs) are rare and heterogeneous, necessitating analysis of surgical outcomes.
- Understanding short- and long-term results of NF-PNET resection is crucial for refining treatment strategies.
Purpose of the Study:
- To analyze the short- and long-term outcomes of patients who underwent surgical resection for NF-PNETs.
- To identify prognostic factors influencing recurrence and inform treatment approaches for this rare entity.
Main Methods:
- Retrospective review of 119 patients with histologically or cytologically confirmed NF-PNETs.
- Data collected included perioperative management, pathologic analysis, and follow-up outcomes.
- Statistical analysis (univariate and multivariate) was performed to identify recurrence predictors.
Main Results:
- Multivariate analysis identified positive lymph nodes, vascular/perineural invasion, and pathology grade G3 as significant prognostic factors for tumor recurrence.
- Univariate analysis showed symptoms, tumor size >4 cm, ENETS stages III-IV, positive lymph nodes, vascular/perineural invasion, and grade G2 were associated with higher recurrence risks.
- Post-operative adjuvant therapy with octreotide in 14 G2/G3 patients without distant metastasis resulted in recurrence in 3 (21.4%) patients.
Conclusions:
- Positive lymph nodes, vascular/peripheral invasion, and pathology grade G3 are significantly related to NF-PNET recurrence.
- Lymph node resection is recommended for patients with NF-PNETs when Fine Needle Aspiration (FNA) biopsy indicates pathology grade G3.
