Analysis of recurrence after the resection of pancreatic neuroendocrine tumors

Abstract

Background and objectives: Outcomes after recurrence of resected pancreatic neuroendocrine tumors (PNETs) are not well described. We aim to assess the rate and sites of recurrence, and its effect on clinical outcomes.

Methods: Retrospective chart review of patients (n = 83) who underwent surgical resection of PNETs at 2 institutions. Patients were treated from September 2002 to July 2010.

Results: There were 13 (16%) recurrences. The most common site of recurrence was the liver (9 patients, 9.6%). The most common treatment of recurrences was chemotherapy (5 patients, 36%). The 1-, 3-, and 5-year disease-free survival was 90.9%, 82.7%, and 72.5%, respectively. Median recurrence-free survival was 127 months. The median follow-up for all PNET patients was 25.8 months (range, 1-140 months). The 3-year survival was 97%. The median follow-up of patients after the diagnosis of a recurrence was 13.8 months. The overall survival for those with and without recurrence was 96.3% and 100%, respectively (P = .36). The age ( P = .002) and lymph node ratio ( P < .001) were predictors of recurrence on multivariate analysis.

Conclusions: Age and lymph node ratio are significant predictors of recurrence after the resection of PNETs with hepatic metastases being the most common. Survival of patients with recurrence is not significantly different from patients without recurrence.

Keywords: liver metastases; lymph node ratio (LNR); predictors of survival.