偶然发现的小型无功能胰腺神经内分泌肿瘤的手术切除与观察等待治疗
Resection versus expectant management of small incidentally discovered nonfunctional pancreatic neuroendocrine tumors.
作者信息
Rosenberg Alex M, Friedmann Patricia, Del Rivero Jaydira, Libutti Steven K, Laird Amanda M
机构信息
Albert Einstein College of Medicine, Bronx, NY.
Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY.
出版信息
Surgery. 2016 Jan;159(1):302-9. doi: 10.1016/j.surg.2015.10.013. Epub 2015 Nov 4.
BACKGROUND
Sporadic, nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are diagnosed with increasing frequency. We compared the risk of tumor growth, metastasis, and mortality between patients treated versus those treated expectantly.
METHOD
A retrospective study of patients seen at our institution with sporadic NF-PNETs, with ≥ 12 months of follow-up. Kaplan-Meier analysis was performed.
RESULTS
Between 1999 and 2014, 35 patients with an incidentally discovered nonfunctional PNET were identified. Twenty underwent resection and 15 were followed with imaging. In the operative group, 8 had NF-PNETs < 2 cm, while 12 had NF-PNETs ≥ 2 cm. In the nonoperative expectant management by serial imaging group, 10 had NF-PNETs < 2 cm while 5 had NF-PNETs ≥ 2 cm. Small NF-PNETs (<2 cm) in either the operative or nonoperative groups demonstrated no evidence of progression or metastasis (median follow-up of 27.8 months). Morbidity in the operative group was 35% with pancreatic pseudocyst the most common.
CONCLUSION
Incidentally discovered NF-PNETs < 2 cm in size can be observed safely with serial imaging.
背景
散发性无功能胰腺神经内分泌肿瘤（NF-PNETs）的诊断频率日益增加。我们比较了接受治疗的患者与接受观察等待的患者之间肿瘤生长、转移和死亡的风险。
方法
对我院诊治的散发性NF-PNETs患者进行回顾性研究，随访时间≥12个月。采用Kaplan-Meier分析。
结果
1999年至2014年，共识别出35例偶然发现的无功能PNET患者。20例接受了手术切除，15例接受影像学随访。手术组中，8例NF-PNETs＜2 cm，12例NF-PNETs≥2 cm。在通过系列影像学检查进行非手术观察等待治疗组中，10例NF-PNETs＜2 cm，5例NF-PNETs≥2 cm。手术组或非手术组中的小NF-PNETs（＜2 cm）均未显示进展或转移迹象（中位随访27.8个月）。手术组的发病率为35%，胰腺假性囊肿最为常见。
结论
偶然发现的直径＜2 cm的NF-PNETs可通过系列影像学检查安全观察。
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