Neuroendocrine tumours of the pancreas: predictors of survival after surgical treatment

Dig Surg. 2005;22(3):157-62. doi: 10.1159/000087148. Epub 2005 Jul 20.

Abstract

Aims: Neuroendocrine tumours of pancreatic and duodenal origin (NETP) are rare and we present a significant experience from a single centre.

Methods: Data was collected on 44 patients who underwent surgery between 1988 and 2002. Since 1997, data have been recorded prospectively on a dedicated database.

Results: Twenty-four patients had functioning tumours (16 insulinomas, 3 gastrinomas, 2 somatostatinomas, 1 vipoma, 1 glucagonoma and 1 carcinoid tumour). Nine functioning tumours and 13 non-functioning had a malignant phenotype. Twenty pancreaticoduodenectomies, 9 local excisions, 7 distal and 2 total pancreatectomies, 5 bypasses and 1 exploratory laparotomy were performed. Fourteen patients (31.8%) had surgical complications, 1 died peri-operatively (2.3%). The overall actuarial survival for resected cases was 74.4 and 42.5% at 5 and 10 years, respectively. Lymph node invasion and metastases were significant predictors of survival by univariate analysis and only the presence of metastases retained significance on multivariate analysis.

Conclusion: Surgical resection is the only curative treatment for NETP. Resection can be safely carried out in a specialist centre and is associated with good long-term survival. The presence of metastases was a significant predictive factor for survival in patients with NEPT in this series.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Digestive System Surgical Procedures
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / surgery*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery*
  • Prognosis
  • Survival Analysis
  • Treatment Outcome