| Objective:To investigate the clinical characteristics and surgical treatment of pancreatic neuroendocrine neoplasms(PNENs), and to analyze the prognostic factors of PNENs.Methods:Data of109PNENs patients in Second Affiliated Hospital of Zhejiang University School of Medicine from June1998to June2014were collected and retrospective analyzed, including age, sex, symptom, Tumor size, pathology, surgical operation and survival.Results:The patients consisted of45(49.5%) males and64(58.7%) females, with a median age of50years (range15-79years).54patients (49.5%) had non-functional tumors,55patients (50.5%) had functional tumors, with54insulinomas and1Somatostatinoma. According to the World Health Organization(WHO) classification(2010) for PNENs, the grade of G1、G2、G3tumors were79(72.5%),20(18.3%),10(9.2%).According to the European Neuroendocrine Tumor Society(ENETS) staging(20106) for PNENs, the stage of Ⅰ、Ⅱ、Ⅲ、Ⅳ were49(45.0%),46(42.2%),7(6.4%),7(6.4%), respectively. All patients received surgical treatments. And108patients underwent radical operation,which included pancreaticoduodenectomy in19cases(17.4%), distal pancreatectomy in35cases (32.1%), enucleation in39cases (35.8%), medial pancreatectomy in12cases(11.0%), and pancreatic head resection in3cases(2.8%). One patient had liver metastasis, without cytoreductive surgery but liver neoplasm biopsy and cholecystectomy. The common postoperative complications were pancreatic fistula (36.7%), wound infection (14.7%) and delayed gastric emptying (13.8%). Two patients had reoperation respectively due to intra-abdominal abscess and postoperative hemorrhage. Univariate analysis showed WHO classification, TNM staging system, liver metastasis, lymph node metastasis, neural invasion were prognostic factors of PNENs.Conclusion:Surgical resection for PNEN resulted in long-term survival. WHO classification、TNM staging are effective in predicting the prognosis of PNEN. Liver metastasis, lymph node metastasis,neural invasion predicted poor prognosis. |
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