Yang Min, Zeng Lin, Zhang Yi, Su An-Ping, Yue Peng-Ju, Tian Bo-le
Department of Hepato-bilio-pancreatic Surgery (MY, YZ, AS, PY, BT); and General Ward of Sports Medicine and Cardiopulmonary Rehabilitation (LZ), West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.
Medicine (Baltimore). 2014 Nov;93(22):e94. doi: 10.1097/MD.0000000000000094.
Our primary aim of the present study was to analyze the clinical characteristics and surgical outcome of nonfunctional pancreatic neuroendocrine tumors (non-F-P-NETs), with an emphasis on evaluating the prognostic value of the newly updated 2010 grading classification of the World Health Organization (WHO).Data of 55 consecutive patients who were surgically treated and pathologically diagnosed as non-F-P-NETs in our single institution from January 2000 to December 2013 were retrospectively collected.This entirety comprised of 55 patients (31 males and 24 females), with a mean age of 51.24 ± 12.95 years. Manifestations of non-F-P-NETs were nonspecific. Distal pancreatectomy, pancreaticoduodenectomy, and local resection of pancreatic tumor were the most frequent surgical procedures, while pancreatic fistula was the most common but acceptable complication (30.3%). The overall 5-year survival rate of this entire cohort was 41.0%, with a median survival time of 60.4 months. Patients who underwent R0 resections obtained a better survival than those who did not (P < 0.005). As for the prognostic analysis, tumor size and lymph invasion were only statistically significant in univariate analysis (P = 0.046 and P < 0.05, respectively), whereas the newly updated 2010 grading classification of WHO (G1 and G2 vs G3), distant metastasis, and surgical margin were all meaningful in both univariate and multivariate analysis (P = 0.045, 0.001, and 0.042, respectively).Non-F-P-NETs are a kind of rare neoplasm, with mostly indolent malignancy. Patients with non-F-P-NETs could benefit from the radical resections. The new WHO criteria, distant metastasis and surgical margin, might be independent predictors for the prognosis of non-F-P-NETs.
本研究的主要目的是分析无功能胰腺神经内分泌肿瘤（non-F-P-NETs）的临床特征及手术结果，重点评估世界卫生组织（WHO）2010年新更新的分级分类的预后价值。回顾性收集了2000年1月至2013年12月在我们单中心接受手术治疗并经病理诊断为non-F-P-NETs的55例连续患者的数据。这55例患者（31例男性和24例女性）的平均年龄为51.24±12.95岁。non-F-P-NETs的表现无特异性。胰体尾切除术、胰十二指肠切除术和胰腺肿瘤局部切除术是最常见的手术方式，而胰瘘是最常见但可接受的并发症（30.3%）。整个队列的5年总生存率为41.0%，中位生存时间为60.4个月。接受R0切除的患者比未接受R0切除的患者生存情况更好（P<0.005）。在预后分析中，肿瘤大小和淋巴结侵犯仅在单因素分析中有统计学意义（分别为P = 0.046和P<0.05），而WHO 2010年新更新的分级分类（G1和G2与G3）、远处转移和手术切缘在单因素和多因素分析中均有意义（分别为P = 0.045、0.001和0.042）。non-F-P-NETs是一种罕见肿瘤，大多为惰性恶性肿瘤。non-F-P-NETs患者可从根治性切除中获益。新的WHO标准、远处转移和手术切缘可能是non-F-P-NETs预后的独立预测因素。
