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Infiltrative Growth Predicts the Risk of Recurrence After Surgery in Well-Differentiated Non-Functioning Pancreatic
Marco Schiavo Lena1, Stefano Partelli2, Valentina Andreasi2
1Pathology Unit, Pancreas Translational and Clinical Research Center, IRCCS Ospedale San Raffaele, ENETS Center of Excellence, Via Olgettina 60, 20132, Milan, Italy. schiavolena.marco@hsr.it.
Endocrine Pathology
|December 23, 2022
Summary
The infiltrative growth pattern of non-functioning pancreatic neuroendocrine tumors (NF-PanNET) significantly predicts patient relapse after surgery. This histological feature offers crucial prognostic information beyond current grading and staging systems for NF-PanNET.
Area of Science:
- Oncology
- Pathology
- Endocrinology
Background:
- Incidence of well-differentiated non-functioning pancreatic neuroendocrine tumors (NF-PanNET) has risen.
- Current prognostic models for NF-PanNET lack predictive power for relapse post-surgery.
- Adjuvant therapies are not established, necessitating improved prognostic tools.
Purpose of the Study:
- To investigate the prognostic value of histological growth patterns in NF-PanNET.
- To determine if growth patterns can predict recurrence risk after surgical resection.
- To assess the potential of incorporating growth patterns into existing NF-PanNET classification systems.
Main Methods:
- Retrospective analysis of 247 patients who underwent surgical resection for NF-PanNET.
- Histological examination of tumor growth patterns, categorizing into non-infiltrative (pattern 1) and infiltrative (pattern 2: local invasion; pattern 3: distant invasion).
- Multivariate analysis to identify predictors of recurrence and survival.
Main Results:
- Infiltrative growth pattern strongly correlated with poorer survival (p < 0.001).
- Pattern 3 (invasion of adjacent organs/major vessels) showed the highest risk of recurrence (HR 15.775, p = 0.015).
- Pattern 2 (invasion of pancreatic parenchyma/peripancreatic tissue) also significantly predicted recurrence (HR 10.136, p = 0.028).
Conclusions:
- Histological infiltrative growth pattern is a significant independent predictor of recurrence in NF-PanNET.
- Growth pattern subclassification (patterns 2 and 3) provides critical prognostic information.
- Incorporating infiltrative growth patterns into current systems could enhance risk stratification and follow-up strategies for NF-PanNET.
