Pancreatic neuroendocrine tumor: A multivariate analysis of factors influencing survival

Eur J Surg Oncol. 2014 Nov;40(11):1564-71. doi: 10.1016/j.ejso.2014.06.004. Epub 2014 Jun 30.

Abstract

Background: The outcomes of pancreatic neuroendocrine tumors are extremely diverse, and determining the best strategy, optimal timing of therapy and the therapeutic results depend on understanding prognostic factors. We determined the clinical, radiological and histological factors associated with survival and tumor recurrence for patients with pancreatic neuroendocrine tumor.

Methods: From January 1, 1991 to December 31, 2011, 127 patients with pancreatic neuroendocrine tumor underwent pancreatectomy. The variables including clinical characteristics, surgical data and pathological findings were examined by univariate and multivariate analyses.

Results: There were 103 patients with non-functional tumors (81%). Sixty-four patients (50%) underwent left pancreatectomy, 51 (42%) patients underwent pancreatico-duodenectomy, 12 (9%) patients underwent enucleation and 2 patients (1%) underwent central pancreatectomy. Forty-eight patients (38%) had synchronous liver metastases. Six patients (5%) required portal vein resection, and 19 (15%) patients required enlarged "en-bloc" resection of adjacent organs. The overall morbidity and mortality rates were 48% and 2.3%, respectively. The 1-, 3- and 5-year overall survival rates were 94%, 84%, and 74%, respectively. In multivariate analyses, synchronous liver metastases (p = 0.02) and portal vein resection (p < 0.01) were independent prognostic factors of survival.

Conclusions: Synchronous liver metastases and portal vein resection were found to be independent factors influencing survival.

Keywords: Liver metastases; Neuroendocrine tumor; Pancreatic surgery; Prognostic factor; Survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / pathology*
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Pancreatectomy
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy
  • Portal Vein / surgery*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome
  • Young Adult