Abstract
BackgroundWell-differentiated pancreatic neuroendocrine tumors (PanNETs) usually have a good prognosis; however, there are patients that experience recurrence after curative resection.AimTo explore recurrence-related risk factors by analyzing clinicopathological data of PanNETs after radical surgery.MethodsClinical and pathological data from 47 patients with well-differentiated PanNETs at China-Japan Friendship Hospital from January 2012 to March 2016 were analyzed retrospectively. Univariate and multivariate analyses of the risk factors of PanNETs for postoperative recurrence were conducted.ResultsAmong the 47 patients with well-differentiated PanNETs, there were 38 cases with non-functioning tumors, 9 cases with functional tumors (6 insulinomas, 1 gastrinoma, 1 glucagonoma, and 1 VIPomas). There are 17 cases (36.2%) in the pancreatic head, 17 (36.2%) in the body and tail, 9 (19.1%) in the tail, and 4 (8.5%) in the body. The median tumor size was 3.65 (IQR 2–5.5) cm. Fourteen cases (29.8%) were NET G1, and 33 cases (70.2%) were NET G2. In regard to the clinical stage, 9 (19.1%) cases were IA, 14 (29.8%) cases were IB, 7 (14.9%) cases were IIA, 14 (29.8%) cases were IIB, and 3 cases unknown. There were 17 patients who presented with postoperative recurrence. Univariate analysis showed that AJCC TNM staging, Ki67 index, vascular invasion, margin status, and the regional stage of the tumors are related to the recurrence of patients with PanNETs (p < 0.05). The results of multivariate analysis showed that Ki67 index ≥ 10% is an independent risk factor for the postoperative recurrence of PanNETs (p < 0.05).ConclusionThe Ki67 index ≥ 10% is an independent risk factor for recurrence in well-differentiated PanNETs after radical surgery, and close surveillance for these patients may be needed.
Highlights
Well-differentiated pancreatic neuroendocrine tumors (PanNETs) usually have a good prognosis; there are patients that experience recurrence after curative resection
The study examined 47 well-differentiated PanNETs after surgery in China-Japan Friendship Hospital in Beijing, from January 2012 to December 2016, with the following inclusion criteria: (1) patients who were diagnosed with NET G1 or NET G2 pancreatic neuroendocrine tumors by surgical pathology according to the 2010 version of the WHO grading after curative resection [6]; (2) patients who were confirmed to have no distant metastasis at the time of diagnosis and who were in a disease-free state after radical operation; and (3) patients who only had one primary tumor and received surgical resection at the primary site were included in this study
G and colleagues suggested that patients at high risk for recurrence after curative resection of G1 or G2 PanNETs can be identified by the Ki67 index which is higher than 5% [11]; Genc C
Summary
Well-differentiated pancreatic neuroendocrine tumors (PanNETs) usually have a good prognosis; there are patients that experience recurrence after curative resection. Neuroendocrine neoplasm (NEN) is a rare and heterogeneous tumor type that originates in peptidergic neurons and neuroendocrine cells. The pancreas is a common site for neuroendocrine tumors. The Surveillance, Epidemiology, and End Results (SEER) database shows that gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are. Zhang et al World Journal of Surgical Oncology (2019) 17:66
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