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. 2020 Feb;22(2):215-223.
doi: 10.1016/j.hpb.2019.05.020. Epub 2019 Jun 21.

Resection of pancreatic neuroendocrine tumors: defining patterns and time course of recurrence

Ding-Hui Dong  1 , Xu-Feng Zhang  2 , Alexandra G Lopez-Aguiar  3 , George Poultsides  4 , Eleftherios Makris  4 , Flavio Rocha  5 , Zaheer Kanji  5 , Sharon Weber  6 , Alexander Fisher  6 , Ryan Fields  7 , Bradley A Krasnick  7 , Kamran Idrees  8 , Paula M Smith  8 , Cliff Cho  9 , Megan Beems  9 , Mary Dillhoff  10 , Shishir K Maithel  3 , Timothy M Pawlik  11
Affiliations

Resection of pancreatic neuroendocrine tumors: defining patterns and time course of recurrence

Ding-Hui Dong et al. HPB (Oxford). 2020 Feb.

Abstract

Background: To define recurrence patterns and time course, as well as risk factors associated with recurrence following curative resection of pNETs.

Method: Patients who underwent curative-intent resection for pNET between 1997 and 2016 were identified from the US Neuroendocrine Tumor Study Group. Data on baseline and tumor-specific characteristics, overall survival (OS), timing and first-site of recurrence, predictors and recurrence management were analyzed.

Results: Among 1020 patients, 154 (15.1%) patients developed recurrence. Among patients who experienced recurrence, 76 (49.4%) had liver-only recurrence, while 35 (22.7%) had pancreas-only recurrence. The proportion of liver-only recurrence increased from 54.3% within one-year after surgery to 61.5% from four-to-six years after surgery; whereas the proportion of pancreas-only recurrence decreased from 26.1% to 7.7% over these time periods. While liver-only recurrence was associated with tumor characteristics, pancreas-only recurrence was only associated with surgical margin status. Patients undergoing curative resection of recurrence had comparable OS with patients who had no recurrence (median OS, pancreas-only recurrence, 133.9 months; liver-only recurrence, not attained; no recurrence, 143.0 months, p = 0.499) CONCLUSIONS: Different recurrence patterns and timing course, as well as risk factors suggest biological heterogeneity of pNET recurrence. A personalized approach to postoperative surveillance and treatment of recurrence disease should be considered.

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Conflict of interest statement

Conflicts of interest

None declared.

Figures

Figure 1
Figure 1
Recurrence patterns of pNET at different time periods
Figure 2
Figure 2
Cumulative recurrence incidence (a) and disease-free survival (b) among patients who experienced different recurrence patterns
Figure 3
Figure 3
a, Overall survival of patients who experienced recurrence versus patients who had no recurrence; b, Survival among patients who underwent curative treatment for recurrence versus patients who received noncurative treatment for recurrence; c, Overall survival of patients who underwent curative treatment for liver-only recurrence or pancreatic recurrence versus patients who had no recurrence
See this image and copyright information in PMC

References

    1. Sandvik OM, Soreide K, Gudlaugsson E, Kvaloy JT, Soreide JA. (2016) Epidemiology and classification of gastroenteropancreatic neuroendocrine neoplasms using current coding criteria. Br J Surg 103:226–232. - PMC - PubMed
    1. Chi W, Warner RRP, Chan DL, Singh S, Segelov E, Strosberg J et al. (2018) Long-term outcomes of gastroenteropancreatic neuroendocrine tumors. Pancreas 47:321–325. - PubMed
    1. Franko J, Feng W, Yip L, Genovese E, Moser AJ. (2010) Non-functional neuroendocrine carcinoma of the pancreas: incidence, tumor biology, and outcomes in 2,158 patients. J Gastrointest Surg 14:541–548. - PubMed
    1. Kuo EJ, Salem RR. (2013) Population-level analysis of pancreatic neuroendocrine tumors 2 cm or less in size. Ann Surg Oncol 20: 2815–2821. - PubMed
    1. Bilimoria KY, Talamonti MS, Tomlinson JS, Stewart AK, Winchester DP, Ko CY et al. (2008) Prognostic score predicting survival after resection of pancreatic neuroendocrine tumors: analysis of 3851 patients. Ann Surg 247:490–500. - PubMed

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