Pancreatic Neuroendocrine Neoplasms:Results Of Surgical Management And Survival Analysis

Objective To evaluate the outcomes of surgical management of pancreatic neuroendocrine neoplasms (PNENs)and to analyze the prognostic factors of PNENs.Methods The medical records of62consecutive patients with PNENs treated from March1995to February2012were retrospectively reviewed. Survival was analyzed with the Kaplan-Meier method.Results All of the patients with a median age of52years (range,22-68years), and39(62.9%) patients were female.42patients (67.7%) had non-functional tumors,20(32.3%) patients had functional tumors. According to the World Health Organization (WHO) classification(2010) and TNM staging for PNENs, the grade of G1、G2、 G3、 uncertain tumors were30(48.4%)、11(17.7%)、13(21.0%)、8(12.9%), respectively. The stage of Ⅰ、Ⅱ、Ⅲ、Ⅳ were46(74.2%)、8(12.9%)、3(4.8%)、5(8.1%), respectively. Liver metastasis、neural invasion were found in5cases(8.1%),5cases(8.1%), respectively.54(87.1%) patients underwent curative resection,13(21.0%) patients underwent laparoscopic operation. The median follow-up time was40months (range,3-209months). The overall1-、3-、5-year survival rates were91.6%、89.3%、86%, respectively. Univariate analysis showed WHO classification (p<0.001), TNM staging system (p<0.001), liver metastasis (p＜0.001)、 neural invasion (p=0.001), resection status (p＜0.001) were prognostic factors of PNENs. Conclusion Surgical resection for PNENs resulted in long-term survival. WHO classification、TNM staging、 resection status are effective in predicting the prognosis of PNENs. Liver metastasis、neural invasion predicted poor prognosis.