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Medline ® Abstract for Reference 49

of 'Surgical resection of sporadic pancreatic neuroendocrine tumors'

Clinical outcome and long-term survival in 118 consecutive patients with neuroendocrine tumours of the pancreas.
Fischer L, Kleeff J, Esposito I, Hinz U, Zimmermann A, Friess H, Büchler MW
Br J Surg. 2008 May;95(5):627-35.
BACKGROUND: The aim was to assess the clinical relevance of the World Health Organization and tumour node metastasis (TNM) classifications in patients with pancreatic neuroendocrine tumours (pNETs).
METHODS: Prospectively collected data from 118 consecutive patients with a pNET receiving surgical intervention were analysed.
RESULTS: Forty-one patients had well differentiated neuroendocrine tumours, 64 had well differentiated neuroendocrine carcinomas and 13 had poorly differentiated neuroendocrine carcinomas. Five-year survival rates were 95, 44 and 0 per cent respectively (P<0.001). There was no difference in survival after R0 and R1/R2 resections in patients with neuroendocrine carcinomas (P = 0.905). In those with well differentiated neuroendocrine carcinomas, any resection and having a clinically non-functional tumour significantly increased survival (P = 0.003 and P = 0.037 respectively). The TNM stage was I in 37 patients, II in 15 patients, III in 32 patients and IV in 34 patients. There were significant differences in 5-year survival between stage I and II (88 and 85 per cent respectively) and stage III and IV (31 and 42 per cent respectively) (P = 0.010).
CONCLUSION: Both classifications accurately reflect the clinical outcome of patients with pNET. The resection status may not be critical for long-term survival in patients with pNET.
Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany.