Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2 cm: interim analysis of prospective ASPEN trial

Stefano Partelli^{1

2}, Sara Massironi^{3

4}, Alessandro Zerbi^{5

6}, Patricia Niccoli⁷, Wooil Kwon⁸, Luca Landoni⁹, Francesco Panzuto¹⁰, Ales Tomazic¹¹, Alberto Bongiovanni¹², Gregory Kaltsas¹³, Alain Sauvanet¹⁴, Emilio Bertani¹⁵, Vincenzo Mazzaferro¹⁶, Martyn Caplin¹⁷, Thomas Armstrong¹⁸, Martin O Weickert¹⁹, John Ramage²⁰, Eva Segelov²¹, Giovanni Butturini²², Stefan Staettner²³, Mauro Cives²⁴, Andrea Frilling²⁵, Carol Anne Moulton^{26

27}, Jin He²⁸, Florian Boesch²⁹, Andreas Selberheer³⁰, Orit Twito^{31

32}, Antonio Castaldi³³, Claudio G De Angelis³⁴, Sebastien Gaujoux³⁵, Katharina Holzer³⁶, Colin H Wilson³⁷, Hussein Almeamar³⁸, Emanuel Vigia³⁹, Francesca Muffatti^{1

2}, Martina Lucà^{3

4}, Andrea Lania^{5

6}, Jacques Ewald⁷, Hongbeom Kim⁸, Roberto Salvia⁹, Maria Rinzivillo¹⁰, Alojz Smid⁴⁰, Andrea Gardini⁴¹, Marina Tsoli¹³, Olivia Hentic¹⁴, Samuele Colombo¹⁵, Davide Citterio¹⁶, Christos Toumpanakis¹⁷, Emma Ramsey¹⁸, Harpal S Randeva⁴², Ray Srirajaskanthan²⁰, Daniel Croagh²¹, Paolo Regi²², Silvia Gasteiger⁴³, Pietro Invernizzi^{3

4}, Cristina Ridolfi⁴⁴, Marc Giovannini⁷, Jin-Young Jang⁸, Claudio Bassi⁹, Massimo Falconi^{1

2}

Affiliations

¹ School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
² Pancreas Translational and Clinical Research Centre, Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
³ Division of Gastroenterology and Centre for Autoimmune Liver Diseases, San Gerardo Hospital, Monza, Italy.
⁴ Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
⁵ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
⁶ IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
⁷ Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
⁸ Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
⁹ General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
¹⁰ Digestive Disease Unit, ENETS Centre of Excellence, Sant' Andrea University Hospital, Rome, Italy.
¹¹ Department of Abdominal Surgery, University Medical Centre, Ljubijana, Slovenia.
¹² Osteoncology and Rare Tumours Centre (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy.
¹³ First Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁴ Department of Pancreatology, Hôpital Beaujon, University of Paris, Paris, France.
¹⁵ Division of Gastrointestinal Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.
¹⁶ Gastrointestinal and Hepato-Pancreatic Surgery and Liver Transplantation Unit, Fondazione, IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute) and Università degli Studi di Milano, Milan, Italy.
¹⁷ ENETS Centre of Excellence, Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK.
¹⁸ Department of Hepatobiliary Surgery, Wessex NET Group ENETS Centre of Excellence, University Hospital Southampton, Southampton, UK.
¹⁹ ARDEN NET Centre, ENETS Centre of Excellence, University Hospitals Coventry and Warwickshire NHS Trust and Warwick Medical School, University of Warwick, Coventry, UK.
²⁰ Kings Health Partners NET Centre, Kings College Hospital London, London, UK.
²¹ Department of Oncology and Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, Victoria, Australia.
²² Department of Surgery, Pederzoli Hospital, Peschiera del Garda, Italy.
²³ Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum Vöcklabruck, Vöcklabruck, Austria.
²⁴ Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy.
²⁵ Department of Surgery and Cancer, Imperial College London, London, UK.
²⁶ Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.
²⁷ Department of Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
²⁸ Department of Surgery, Johns Hopkins University School of Medical, Baltimore, Maryland, USA.
²⁹ Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
³⁰ Section Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University, Vienna, Austria.
³¹ Endocrine Institute, Meir Medical Center, Kfar-Sava, Israel.
³² Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
³³ Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
³⁴ Gastroenterology Unit, Department of Medical Sciences, City of Health and Science Hospital, Turin, Italy.
³⁵ Department of Digestive, Hepatobiliary and Endocrine Surgery, Paris Sorbonne University, Pitiè Salpétrière Hospital, Paris, France.
³⁶ Department of Visceral-, Thoracic- and Vascular Surgery, Section of Endocrine Surgery, University Hospital Marburg (UKGM), Marburg, Germany.
³⁷ Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
³⁸ National NET Centre and ENETS Centre of Excellence, St Vincent's University Hospital, Dublin, Ireland.
³⁹ Hepato-Biliary-Pancreatic and Transplantation Centre, Curry Cabral Hospital, CHULC, Lisbon, Portugal.
⁴⁰ Department of Gastroenterology and Hepatology, University Medical Centre Ljubijana, Ljubljana, Slovenia.
⁴¹ General and Oncological Surgery Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
⁴² Warwick Medical School, University of Warwick, Coventry, UK.
⁴³ Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
⁴⁴ Pancreatic Surgery Unit, Humanitas Clinical and Research Hospital-IRCCS, Rozzano, Milan, Italy.

PMID: 35986682
PMCID: PMC10364756
DOI: 10.1093/bjs/znac267

Clinical Trial

Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2 cm: interim analysis of prospective ASPEN trial

Stefano Partelli et al. Br J Surg. 2022.

. 2022 Nov 22;109(12):1186-1190.

doi: 10.1093/bjs/znac267.

Authors

Affiliations

¹ School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
² Pancreas Translational and Clinical Research Centre, Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
³ Division of Gastroenterology and Centre for Autoimmune Liver Diseases, San Gerardo Hospital, Monza, Italy.
⁴ Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
⁵ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
⁶ IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
⁷ Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
⁸ Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
⁹ General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
¹⁰ Digestive Disease Unit, ENETS Centre of Excellence, Sant' Andrea University Hospital, Rome, Italy.
¹¹ Department of Abdominal Surgery, University Medical Centre, Ljubijana, Slovenia.
¹² Osteoncology and Rare Tumours Centre (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy.
¹³ First Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁴ Department of Pancreatology, Hôpital Beaujon, University of Paris, Paris, France.
¹⁵ Division of Gastrointestinal Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.
¹⁶ Gastrointestinal and Hepato-Pancreatic Surgery and Liver Transplantation Unit, Fondazione, IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute) and Università degli Studi di Milano, Milan, Italy.
¹⁷ ENETS Centre of Excellence, Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK.
¹⁸ Department of Hepatobiliary Surgery, Wessex NET Group ENETS Centre of Excellence, University Hospital Southampton, Southampton, UK.
¹⁹ ARDEN NET Centre, ENETS Centre of Excellence, University Hospitals Coventry and Warwickshire NHS Trust and Warwick Medical School, University of Warwick, Coventry, UK.
²⁰ Kings Health Partners NET Centre, Kings College Hospital London, London, UK.
²¹ Department of Oncology and Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, Victoria, Australia.
²² Department of Surgery, Pederzoli Hospital, Peschiera del Garda, Italy.
²³ Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum Vöcklabruck, Vöcklabruck, Austria.
²⁴ Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy.
²⁵ Department of Surgery and Cancer, Imperial College London, London, UK.
²⁶ Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.
²⁷ Department of Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
²⁸ Department of Surgery, Johns Hopkins University School of Medical, Baltimore, Maryland, USA.
²⁹ Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
³⁰ Section Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University, Vienna, Austria.
³¹ Endocrine Institute, Meir Medical Center, Kfar-Sava, Israel.
³² Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
³³ Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
³⁴ Gastroenterology Unit, Department of Medical Sciences, City of Health and Science Hospital, Turin, Italy.
³⁵ Department of Digestive, Hepatobiliary and Endocrine Surgery, Paris Sorbonne University, Pitiè Salpétrière Hospital, Paris, France.
³⁶ Department of Visceral-, Thoracic- and Vascular Surgery, Section of Endocrine Surgery, University Hospital Marburg (UKGM), Marburg, Germany.
³⁷ Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
³⁸ National NET Centre and ENETS Centre of Excellence, St Vincent's University Hospital, Dublin, Ireland.
³⁹ Hepato-Biliary-Pancreatic and Transplantation Centre, Curry Cabral Hospital, CHULC, Lisbon, Portugal.
⁴⁰ Department of Gastroenterology and Hepatology, University Medical Centre Ljubijana, Ljubljana, Slovenia.
⁴¹ General and Oncological Surgery Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
⁴² Warwick Medical School, University of Warwick, Coventry, UK.
⁴³ Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
⁴⁴ Pancreatic Surgery Unit, Humanitas Clinical and Research Hospital-IRCCS, Rozzano, Milan, Italy.

PMID: 35986682
PMCID: PMC10364756
DOI: 10.1093/bjs/znac267

No abstract available

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Figures

**Fig. 1**
Study flow chart NF-PanNEN, non-functioning pancreatic neuroendocrine neoplasm.

See this image and copyright information in PMC

References

1. Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Yet al. . Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 2017;3:1335–1342 - PMC - PubMed
1. Lee LC, Grant CS, Salomao DR, Fletcher JG, Takahashi N, Fidler JLet al. . Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): role for nonoperative management. Surgery 2012;152:965–974 - PubMed
1. Sadot E, Reidy-Lagunes DL, Tang LH, Do RKG, Gonen M, D’Angelica MIet al. . Observation versus resection for small asymptomatic pancreatic neuroendocrine tumors: a matched case–control study. Ann Surg Oncol 2016;23:1361–1370 - PMC - PubMed
1. Barenboim A, Lahat G, Nachmany I, Nakache R, Goykhman Y, Geva Ret al. . Resection versus observation of small asymptomatic nonfunctioning pancreatic neuroendocrine tumors. J Gastrointest Surg 2019;24:1366–1374 - PubMed
1. Partelli S, Cirocchi R, Crippa S, Cardinali L, Fendrich V, Bartsch DKet al. . Systematic review of active surveillance versus surgical management of asymptomatic small non-functioning pancreatic neuroendocrine neoplasms. Br J Surg 2017;104:34–41 - PubMed

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Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2 cm: interim analysis of prospective ASPEN trial

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Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2 cm: interim analysis of prospective ASPEN trial

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