Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
- 주제(키워드) nonfunctioning neuroendocrine tumor of pancreas , prognosis , resection , risk factors
- 주제(기타) Oncology
- 설명문(일반) [Han, In Woong; Yoon, So Jeong; Heo, Jin Seok] Sungkyunkwan Univ, Div Hepatobiliary & Pancreat Surg, Sch Med, Dept Surg,Samsung Med Ctr, 81 Irwon Ro, Seoul 06351, South Korea; [Park, Jangho; Park, Sang-Jae] Natl Canc Ctr, Res Inst & Hosp, Ctr Liver & Pancreatobiliary Canc, Goyang 10408, South Korea; [Park, Eun Young] Natl Canc Ctr, Res Inst & Hosp, Biostat Collaborat Team, 323 Ilsan Ro, Goyang Si 10408, South Korea; [Jin, Gang] Second Mil Med Univ, Changhai Hosp, Dept Hepatobiliary Pancreat Surg, Shanghai 200433, Peoples R China; [Hwang, Dae Wook] Univ Ulsan, Coll Med, Asan Med Ctr, Div Hepatobiliary & Pancreat Surg,Dept Surg, Seoul 05505, South Korea; [Jiang, Kuirong] Nanjing Med Univ, Affiliated Hosp 1, Pancreas Ctr, Dept Gen Surg, Nanjing 210029, Peoples R China; [Kwon, Wooil] Seoul Natl Univ, Coll Med, Dept Surg, Seoul 03080, South Korea; [Kwon, Wooil] Seoul Natl Univ, Coll Med, Canc Res Inst, Seoul 03080, South Korea; [Xu, Xuefeng; Lou, Wenhui] Fudan Univ, Zhongshan Hosp, Dept Pancreat Surg, Shanghai 200032, Peoples R China; [Fu, De-Liang] Fudan Univ, Huashan Hosp, Dept Pancreat Surg, Shanghai 200040, Peoples R China; [Lee, Woo Jung] Yonsei Univ, Div Hepatobiliary & Pancreat Surg, Pancreatobiliary Canc Ctr, Yonsei Canc Ctr,Severance Hosp,Dept Surg,Coll Med, Seoul 03722, South Korea; [Bai, Xueli] Zhejiang Univ, Affiliated Hosp 2, Dept Hepatobiliary & Pancreat Surg, Hangzhou 310009, Peoples R China; [Yoon, Yoo-Seok] Seoul Natl Univ, Coll Med, Bundang Hosp, Dept Surg, Seoul 13620, South Korea; [Yang, Yin-Mo] Peking Univ, Dept Gen Surg, Hosp 1, Beijing 100034, Peoples R China; [Ahn, Keun Soo] Keimyung Univ, Sch Med, Dongsan Hosp, Dept Surg, Daegu 42601, South Korea; [Yuan, Chunhui] Peking Univ, Hosp 3, Dept Gen Surg, Beijing 100083, Peoples R China; [Lee, Hyeon Kook] Ewha Womans Univ, Coll Med, Dept Surg, Seoul 07804, South Korea; [Sun, Bei] Harbin Med Univ, Affiliated Hosp 1, Dept Hepatobiliary & Pancreat Surg, Harbin 150001, Peoples R China; [Park, Eun Kyu] Chonnam Natl Univ Hosp, Dept Gen Surg, Div Hepatobiliary & Pancreat Surg, Gwangju 61469, South Korea; [Lee, Seung Eun] Chung Ang Univ, Coll Med, Chung Ang Univ Hosp, Dept Surg, Seoul 06973, South Korea; [Kang, Sunghwa] Dong A Univ Hosp, Dept Surg, Div Hepatobiliary & Pancreat Surg, Busan 49201, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 MDPI
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190880
- 본문언어 영어
- Published As https://doi.org/10.3390/cancers14041038
- PubMed https://pubmed.ncbi.nlm.nih.gov/35205787
초록/요약
Simple Summary No consensus has been reached regarding whether nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) <= 2 cm should be resected or observed. In this retrospective international multicenter study, 483 patients who underwent resection for NF-pNETs <= 2 cm in 18 institutions from 2000 to 2017 were enrolled and their medical records were reviewed. Tumor size > 1.5 cm, Ki-67 index >= 3%, and nodal metastasis were independent adverse prognostic factors for survival after multivariable analysis. NF-pNET patients with tumors <= 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs. Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors <= 2 cm do not necessarily need surgery. This study aims to establish a surgical treatment plan for NF-pNETs <= 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs <= 2 cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. The median age was 56 (range 16-80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (>1.5 cm; HR 4.28, 95% CI 1.80-10.18, p = 0.001) and nodal metastasis (HR 3.32, 95% CI 1.29-8.50, p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (HR 4.36, 95% CI 1.48-12.87, p = 0.008) and high Ki-67 index (>= 3%; HR 9.06, 95% CI 3.01-27.30, p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs <= 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5 cm, Ki-67 index >= 3%, or nodal metastasis was present. NF-pNET patients with tumors <= 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs.
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