View : 371 Download: 0
Risk Factors for Recurrence in Pancreatic Neuroendocrine Tumor and Size as a Surrogate in Determining the Treatment Strategy: A Korean Nationwide Study
- Title
- Risk Factors for Recurrence in Pancreatic Neuroendocrine Tumor and Size as a Surrogate in Determining the Treatment Strategy: A Korean Nationwide Study
- Authors
- Kwon W.; Jang J.-Y.; Song K.B.; Hwang D.W.; Kim S.C.; Heo J.S.; Choi D.W.; Hwang H.K.; Kang C.M.; Yoon Y.-S.; Han H.-S.; Park J.S.; Hong T.H.; Cho C.K.; Ahn K.S.; Lee H.; Lee S.E.; Jeong C.-Y.; Roh Y.H.; Kim H.J.; Choi S.; Kim S.-W.; Lee W.J.; Han I.W.; Yoon D.S.; Kang K.J.; Min S.K.; Lee H.K.; Hong S.C.
- Ewha Authors
- 이희성
- SCOPUS Author ID
- 이희성
- Issue Date
- 2021
- Journal Title
- Neuroendocrinology
- ISSN
- 0028-3835
- Citation
- Neuroendocrinology vol. 111, no. 8, pp. 794 - 804
- Keywords
- Neuroendocrine tumor; Pancreas; Recurrence; Risk factor; Treatment algorithm
- Publisher
- S. Karger AG
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Introduction: The prognostic factors of pancreatic neuroendocrine tumor (PNET) are unclear, and the treatment guidelines are insufficient. This study aimed to suggest a treatment algorithm for PNET based on risk factors for recurrence in a large cohort. Methods: Data of 918 patients who underwent curative intent surgery for PNET were collected from 14 tertiary centers. Risk factors for recurrence and survival analyses were performed. Results: The 5-year disease-free survival (DFS) rate was 86.5%. Risk factors for recurrence included margin status (R1, hazard ratio [HR] 2.438; R2, HR 3.721), 2010 WHO grade (G2, HR 3.864; G3, HR 7.352), and N category (N1, HR 2.273). A size of 2 cm was significant in the univariate analysis (HR 8.511) but not in the multivariate analysis (p = 0.407). Tumor size was not a risk factor for recurrence, but strongly reflected 2010 WHO grade and lymph node (LN) status. Tumors ≤2 cm had lower 2010 WHO grade, less LN metastasis (p < 0.001), and significantly longer 5-year DFS (77.9 vs. 98.2%, p < 0.001) than tumors >2 cm. The clinicopathologic features of tumors <1 and 1-2 cm were similar. However, the LN metastasis rate was 10.3% in 1-2-cm sized tumors and recurrence occurred in 3.0%. Tumors <1 cm in size did not have any LN metastasis or recurrence. Discussion/Conclusion: Radical surgery is needed in suspected LN metastasis or G3 PNET or tumors >2 cm. Surveillance for <1-cm PNETs should be sufficient. Tumors sized 1-2 cm require limited surgery with LN resection, but should be converted to radical surgery in cases of doubtful margins or LN metastasis. © 2020 S. Karger AG, Basel.
- DOI
- 10.1159/000511875
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
There are no files associated with this item.
- Export
- RIS (EndNote)
- XLS (Excel)
- XML