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- Title
Long-term morbidity and mortality in patients diagnosed with an insulinoma.
- Authors
Peltola, Elina; Hannula, Päivi; Huhtala, Heini; Metso, Saara; Sand, Juhani; Laukkarinen, Johanna; Tiikkainen, Mirja; Sirén, Jukka; Soinio, Minna; Nuutila, Pirjo; Moilanen, Leena; Laaksonen, David E.; Ebeling, Tapani; Arola, Johanna; Schalin-Jäntti, Camilla; Jaatinen, Pia
- Abstract
Objective: Insulinomas are rare functional pancreatic neuroendocrine tumo urs. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the mor bidity and mortality in the Finnish insulinoma cohort. Design: Retrospective cohort study. Methods: Incidence of endocrine, cardiovascular, gastrointestinal and p sychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland dur ing 1980-2010 (n = 79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched c ontrols, using the Mantel-Haenszel method. Overall survival was analysed with Kaplan-Meier and Cox regression anal yses. Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation (rate ratio (RR): 2.07 (95% CI: 1.02-4.22)), intestinal obstruction (18.65 (2.09-166.86)), and possibly breast (4.46 (1.29-15.39) and kidney cancers (RR n ot applicable) was increased among insulinoma patients vs controls, P < 0.05 for all comparisons. Endocrine disorders and pancreatic d iseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a nonmetastatic insulinoma (n = 70) was similar to that of controls, but for patients with dis tant metastases (n = 9), the survival was significantly impaired (median 3.4 years). Conclusions: The long-term prognosis of patients with a non-metastatic insu linoma is similar to the general population, except for an increased incidence of atrial fibrillation, intest inal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.
- Subjects
FINLAND; INSULINOMA; DIAGNOSIS; OVERALL survival; ATRIAL fibrillation; BREAST cancer; RENAL cancer
- Publication
European Journal of Endocrinology, 2021, Vol 185, Issue 4, p577
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-21-0230