Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors

Carregando...
Imagem de Miniatura
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
HINDAWI LTD
Citação
GASTROENTEROLOGY RESEARCH AND PRACTICE, v.2021, article ID 6650386, 5p, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background. The incidence of small nonfunctioning neuroendocrine pancreatic tumors (NF-PNETs) has been increasing systematically in the last few decades. Surgical resection was once considered the treatment of choice but has been questioned in the direction of a more conservative approach for selected patients. Our aim was to analyze the outcome of surgical resection of small (<= 3cm) NF-PNETs. Methods. We retrospectively evaluated 14 patients with sporadic NF-PNETs who underwent pancreatic resection. Data were collected from patients' medical records. Results. Of the 14 patients included, 35.71% were men, and the average age was 52.36 +/- 20.36 years. Comorbidities were present in 92.86% of the cases. The incidence of postoperative complications was 42.86%, the 30-day mortality was zero, and the length of follow-up was 3.31 +/- 3.0 years. The results of pathological evaluations revealed WHO grade I in 42.86% of cases, II in 21.43%, and neuroendocrine carcinoma in 35.71%. The median tumor size was 1.85cm (range, 0.5-3cm), and 2 cases had synchronous metastasis. The median TNM stage was IIa (range, I-IV). The disease-free and patient survival rates were 87.5% and 100% at 3 years and 43.75% and 75% at 10 years, respectively. The tumor pathological grade was significantly higher in head tumors than body-tail tumors, but there were no differences with respect to tumor size and TNM staging. Conclusion. A surgical approach to treat small sporadic NF-PNETs is safe with low mortality and high patient survival. Based on these data, small pancreatic head tumors can be more aggressive, suggesting that surgical resection is still the best option to treat small nonfunctioning PNETS. Thus, conservative treatment should be indicated very cautiously for only cases with absolute contraindications for surgery.
Palavras-chave
Referências
  1. Bar-Moshe Y, 2017, WORLD J GASTRO ENDOS, V9, P153, DOI 10.4253/wjge.v9.i4.153
  2. Bettini R, 2011, SURGERY, V150, P75, DOI 10.1016/j.surg.2011.02.022
  3. Dasari A, 2017, JAMA ONCOL, V3, P1335, DOI 10.1001/jamaoncol.2017.0589
  4. Dindo D, 2004, ANN SURG, V240, P205, DOI 10.1097/01.sla.0000133083.54934.ae
  5. Falconi M, 2016, NEUROENDOCRINOLOGY, V103, P153, DOI 10.1159/000443171
  6. Falconi M, 2012, NEUROENDOCRINOLOGY, V95, P120, DOI 10.1159/000335587
  7. Gaujoux S, 2013, J CLIN ENDOCR METAB, V98, P4784, DOI 10.1210/jc.2013-2604
  8. Gorelik M, 2018, SURG CLIN N AM, V98, P157, DOI 10.1016/j.suc.2017.09.014
  9. Haynes AB, 2011, ARCH SURG-CHICAGO, V146, P534, DOI 10.1001/archsurg.2011.102
  10. Inzani F, 2018, ENDOCRIN METAB CLIN, V47, P463, DOI 10.1016/j.ecl.2018.04.008
  11. Kloppel G, 2010, VIRCHOWS ARCH, V456, P595, DOI 10.1007/s00428-010-0924-6
  12. Kuo EJ, 2013, ANN SURG ONCOL, V20, P2815, DOI 10.1245/s10434-013-3005-7
  13. Kuo JH, 2014, SURG CLIN N AM, V94, P689, DOI 10.1016/j.suc.2014.02.010
  14. Kurita Y, 2020, J GASTROENTEROL, V55, P543, DOI 10.1007/s00535-019-01655-w
  15. Lawrence B, 2011, ENDOCRIN METAB CLIN, V40, P1, DOI 10.1016/j.ecl.2010.12.005
  16. Lee LC, 2012, SURGERY, V152, P965, DOI 10.1016/j.surg.2012.08.038
  17. Libutti SK, 2013, J CLIN ENDOCR METAB, V98, P4670, DOI 10.1210/jc.2013-3696
  18. Liu B, 2019, J GASTROENTEROL, V54, P819, DOI 10.1007/s00535-019-01570-0
  19. Liu YY, 2019, J CANCER, V10, P6349, DOI 10.7150/jca.27779
  20. Partelli S, 2017, BRIT J SURG, V104, P34, DOI 10.1002/bjs.10312
  21. Ricci C, 2017, ANN SURG ONCOL, V24, P2603, DOI 10.1245/s10434-017-5946-8
  22. Rosenberg AM, 2016, SURGERY, V159, P302, DOI 10.1016/j.surg.2015.10.013
  23. Sadot E, 2016, ANN SURG ONCOL, V23, P1361, DOI 10.1245/s10434-015-4986-1
  24. Sallinen V, 2015, SURGERY, V158, P1557, DOI 10.1016/j.surg.2015.04.035
  25. Sharpe SM, 2015, J GASTROINTEST SURG, V19, P117, DOI 10.1007/s11605-014-2615-0
  26. Singh S, 2015, ANN SURG ONCOL, V22, P2685, DOI 10.1245/s10434-014-4145-0
  27. Galeano CU, 2017, CIR ESPAN, V95, P83, DOI 10.1016/j.ciresp.2016.12.006
  28. Yang G, 2017, INT J ONCOL, V50, P567, DOI 10.3892/ijo.2016.3826
  29. You Y, 2019, CANCER RES TREAT, V51, P1639, DOI 10.4143/crt.2019.023