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- Title
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.
- Authors
Abdalla, Thaer S. A.; Klinkhammer-Schalke, Monika; Zeissig, Sylke Ruth; Tol, Kees Kleihues-van; Honselmann, Kim C.; Braun, Rüdiger; Bolm, Louisa; Lapshyn, Hryhoriy; Litkevych, Stanislav; Zemskov, Sergii; Begum, Nehara; Kulemann, Birte; Hummel, Richard; Wellner, Ulrich Friedrich; Keck, Tobias; Deichmann, Steffen
- 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.
- Subjects
NEUROENDOCRINE tumors; PROGNOSIS; PROGRESSION-free survival; OVERALL survival; SURGICAL margin; PANCREATIC tumors
- Publication
Journal of Cancer Research & Clinical Oncology, 2023, Vol 149, Issue 11, p8535
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-023-04785-0