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Updated: May 20, 2025
Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
Prognosis of small pancreatic neuroendocrine neoplasms: Functionality matters
Qingquan Tan1, Li Liu2, Xubao Liu1
1Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Background:
This study aimed to evaluate potential difference in clinicopathological characteristics, prognosis as well as the genetic bases between insulinomas and non-functional pancreatic neuroendocrine neoplasms (NF-PNENs).
Method:
We analyzed data from 241 patients who underwent resection for PNENs measuring 1-2 cm at West China Hospital between 2002 and 2020.
Results:
NF-PNENs were more likely to show lymph node involvement (P < 0.001), perineural invasion (P = 0.025), and a more advanced tumor grade (P < 0.001). In multivariate analysis, NF-PNENs, when combined with lymph node metastasis and WHO G2/G3 grading, independently decreased recurrence-free survival [hazard ratio (HR), 4.72; P = 0.014]. Whole exome sequencing revealed that most of the top 20 somatic mutated genes (90 %, 36/40) between insulinomas and NF-PNENs are different. Besides, all copy number variant (CNV) patterns were present in NF-PNENs, whereas insulinomas were more likely to exhibit CNV amplification.
Conclusion:
Insulinomas and small NF-PNENs exhibit distinct tumor biology, prognosis, and genetic backgrounds, which may inform changes in surgical management and postoperative follow-up strategies for these patients.
