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Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
- Title
- Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries
- Authors
- Han I.W.; Park J.; Park E.Y.; Yoon S.J.; Jin G.; Hwang D.W.; Jiang K.; Kwon W.; Xu X.; Heo J.S.; Fu D.-L.; Lee W.J.; Bai X.; Yoon Y.-S.; Yang Y.-M.; Ahn K.S.; Yuan C.; Lee H.K.; Sun B.; Park E.K.; Lee S.E.; Kang S.; Lou W.; Park S.-J.
- Ewha Authors
- 이현국
- SCOPUS Author ID
- 이현국
- Issue Date
- 2022
- Journal Title
- Cancers
- ISSN
- 2072-6694
- Citation
- Cancers vol. 14, no. 4
- Keywords
- Nonfunctioning neuroendocrine tumor of pancreas; Prognosis; Resection; Risk factors
- Publisher
- MDPI
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- 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. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- DOI
- 10.3390/cancers14041038
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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