Related Experiment Video
Updated: Sep 15, 2025
Author Spotlight: Reprogramming Cancer Cells to iPSCs to Study Disease Progression and Treatment Targets
Published on: February 2, 2024
Prognostic Factors and Management Approaches for Small Nonfunctional Pancreatic Neuroendocrine Tumors: Insights from
Haiyi Hu1, Chuyan Chen1, Zhibo Zheng2
1Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Beijing, China.
Objective:
To explore the optimal management strategies for small-sized nonfunctional pancreatic neuroendocrine tumors (NF-PanNETs) and to assess the rationale for the 'wait and see' approach.
Methods:
This retrospective study analyzed data from 2,052 patients with small-sized NF-PanNETs (tumor size ≤20 mm) diagnosed between 2004 and 2019. Patients were further divided into two groups: those with tumors ≤10 mm (n = 573) and those with tumors 11-20 mm (n = 1,479). Demographic information, clinical characteristics, and survival outcomes were obtained and compared using the Surveillance, Epidemiology, and End Results (SEER) database.
Results:
Tumors ≤10 mm were less likely to exhibit adjacent structure invasion (p = 0.005), lymph node involvement (p = 0.028), or distant metastasis (p < 0.001). Among T1N0M0 patients, both surgery and surveillance yielded similar cancer-specific survival (CSS) for those with tumors ≤10 mm, while surgery was significantly associated with better CSS for patients with tumors in the 11-20 mm range (p = 0.040). Multivariate analyses identified age >65 years, poor differentiation, T4 stage, and M1 stage as independent predictive factors for worse outcomes (all p < 0.001).
Conclusions:
Compared to NF-PanNETs ≤10 mm, tumors sized between 11 and 20 mm are associated with higher risks of adjacent structure invasion, lymph node involvement, and distant metastasis. Tumors ≤10 mm can be safely monitored with active surveillance.
Insights
Small nonfunctional pancreatic neuroendocrine tumors (NF-PanNETs) ≤10mm can be safely monitored. Larger tumors (11-20mm) have higher risks and may benefit from surgery for better survival outcomes.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Small nonfunctional pancreatic neuroendocrine tumors (NF-PanNETs) require optimal management strategies.
- The 'wait and see' approach is often considered for small NF-PanNETs.
Purpose of the Study:
- To determine optimal management for small NF-PanNETs (≤20mm).
- To evaluate the 'wait and see' approach for NF-PanNETs based on tumor size.
Main Methods:
- Retrospective analysis of 2,052 patients with small NF-PanNETs (≤20mm) from 2004-2019.
- Comparison of tumors ≤10mm (n=573) versus 11-20mm (n=1,479) using SEER database.
- Analysis of demographic, clinical, and survival data.
Main Results:
- Tumors ≤10mm showed significantly lower rates of invasion, lymph node, and distant metastasis.
- For T1N0M0 patients, surveillance and surgery had similar cancer-specific survival (CSS) for tumors ≤10mm.
- Surgery improved CSS for tumors 11-20mm (p=0.040), while age >65, poor differentiation, and advanced stage predicted worse outcomes.
Conclusions:
- Tumors 11-20mm present higher risks of invasion, metastasis, and lymph node involvement compared to tumors ≤10mm.
- Active surveillance is a safe management strategy for NF-PanNETs ≤10mm.
- Surgical intervention may be more beneficial for larger NF-PanNETs (11-20mm).
