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. 2023 Sep;149(11):8535-8543.
doi: 10.1007/s00432-023-04785-0. Epub 2023 Apr 24.

Prognostic factors after resection of locally advanced non-functional pancreatic neuroendocrine neoplasm: an analysis from the German Cancer Registry Group of the Society of German Tumor Centers

Thaer S A Abdalla  1 , Monika Klinkhammer-Schalke  2 , Sylke Ruth Zeissig  2   3 , Kees Kleihues-van Tol  2 , Kim C Honselmann  4 , Rüdiger Braun  4 , Louisa Bolm  4 , Hryhoriy Lapshyn  4 , Stanislav Litkevych  4 , Sergii Zemskov  5 , Nehara Begum  4   6 , Birte Kulemann  4 , Richard Hummel  4 , Ulrich Friedrich Wellner  4 , Tobias Keck  7 , Steffen Deichmann  4
Affiliations

Prognostic factors after resection of locally advanced non-functional pancreatic neuroendocrine neoplasm: an analysis from the German Cancer Registry Group of the Society of German Tumor Centers

Thaer S A Abdalla et al. J Cancer Res Clin Oncol. 2023 Sep.

Abstract

Objective: The available literature regarding outcome after pancreatic resection in locally advanced non-functional pNEN (LA-pNEN) is sparse. Therefore, this study evaluates the current survival outcomes and prognostic factors in after resection of LA-pNEN.

Materials and methods: This population-based analysis was derived from 17 German cancer registries from 2000 to 2019. Patients with upfront resected non-functional non-metastatic LA-pNEN were included.

Results: Out of 2776 patients with pNEN, 277 met the inclusion criteria. 137 (45%) of the patients were female. The median age was 63 ± 18 years. Lymph node metastasis was present in 45%. G1, G2 and G3 pNEN were found in 39%, 47% and 14% of the patients, respectively. Resection of LA-pNEN resulted in favorable 3-, 5- and 10-year overall survival of 79%, 74%, and 47%. Positive resection margin was the only potentially modifiable independent prognostic factor for overall survival (HR 1.93, 95% CI 1.71-3.69, p value = 0.046), whereas tumor grade G3 (HR 5.26, 95% CI 2.09-13.25, p value < 0.001) and lymphangiosis (HR 2.35, 95% CI 1.20-4.59, p value = 0.012) were the only independent prognostic factors for disease-free survival.

Conclusion: Resection of LA-pNEN is feasible and associated with favorable overall survival. G1 LA-pNEN with negative resection margins and absence of lymph node metastasis and lymphangiosis might be considered as cured, while those not fulfilling these criteria might be considered as a high-risk group for disease progression. Herein, negative resection margins represent the only potentially modifiable prognostic factor in LA-pNEN but seem to be influenced by tumor grade.

Keywords: Pancreatic neuroendocrine neoplasms; Population-based analysis; Prognostic factors; Resection margin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plot for overall survival according to tumor differentiation in locally advanced pNEN
Fig. 2
Fig. 2
Kaplan–Meier plot for overall survival according to tumor location in locally advanced pNEN
Fig. 3
Fig. 3
Kaplan–Meier plot for overall survival according to resection margin in locally advanced pNEN
See this image and copyright information in PMC

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