Resection Versus Observation of Small Asymptomatic Nonfunctioning Pancreatic Neuroendocrine Tumors.


Journal

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084

Informations de publication

Date de publication:
06 2020
Historique:
received: 16 01 2019
accepted: 26 05 2019
pubmed: 15 6 2019
medline: 15 4 2021
entrez: 15 6 2019
Statut: ppublish

Résumé

Management of asymptomatic, nonfunctioning small pancreatic neuroendocrine tumors (PNETs) is controversial because of their overall good prognosis, and the morbidity and mortality associated with pancreatic surgery. Our aim was to compare the outcomes of resection with expectant management of patients with small asymptomatic PNETs. Retrospective review of patients with nonfunctioning asymptomatic PNETs < 2 cm that underwent resection or expectant management at the Tel-Aviv Medical Center between 2001 and 2018. Forty-four patients with small asymptomatic, biopsy-proven low-grade PNETs with a KI67 proliferative index < 3% were observed for a mean of 52.48 months. Gallium No patients with asymptomatic low-grade small PNETs treated by expectant management were diagnosed with regional or systemic metastases after a 52.8-month follow-up. Local tumor progression rate was 2.1%. Surgery has excellent long-term outcomes, but it harbors significant morbidity and mortality. Observation can be considered for selected patients with asymptomatic, small, low grade PNETs.

Sections du résumé

BACKGROUND
Management of asymptomatic, nonfunctioning small pancreatic neuroendocrine tumors (PNETs) is controversial because of their overall good prognosis, and the morbidity and mortality associated with pancreatic surgery. Our aim was to compare the outcomes of resection with expectant management of patients with small asymptomatic PNETs.
METHODS
Retrospective review of patients with nonfunctioning asymptomatic PNETs < 2 cm that underwent resection or expectant management at the Tel-Aviv Medical Center between 2001 and 2018.
RESULTS
Forty-four patients with small asymptomatic, biopsy-proven low-grade PNETs with a KI67 proliferative index < 3% were observed for a mean of 52.48 months. Gallium
CONCLUSIONS
No patients with asymptomatic low-grade small PNETs treated by expectant management were diagnosed with regional or systemic metastases after a 52.8-month follow-up. Local tumor progression rate was 2.1%. Surgery has excellent long-term outcomes, but it harbors significant morbidity and mortality. Observation can be considered for selected patients with asymptomatic, small, low grade PNETs.

Identifiants

pubmed: 31197692
doi: 10.1007/s11605-019-04285-y
pii: 10.1007/s11605-019-04285-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1366-1374

Commentaires et corrections

Type : CommentIn

Auteurs

Alex Barenboim (A)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Guy Lahat (G)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Ido Nachmany (I)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Richard Nakache (R)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Yaakov Goykhman (Y)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Ravit Geva (R)

Institute of Oncology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Ester Osher (E)

Department of Endocrinology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Erez Scapa (E)

Institute of Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Ido Wolf (I)

Institute of Oncology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Lior Orbach (L)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Eli Brazowski (E)

Institute of Pathology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Ofer Isakov (O)

Department of Internal Medicine "T", Tel-Aviv Medical Center, (affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.), Tel Aviv, Israel.

Joseph M Klausner (JM)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel.

Nir Lubezky (N)

Unit of Liver Surgery Department of Surgery, Tel-Aviv Medical Center, Tel Aviv, Israel. nirl@tlvmc.gov.il.

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