From the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Pancreas. 2020 Feb;49(2):249-254. doi: 10.1097/MPA.0000000000001477.
Given the lack of consensus on surveillance guidelines after pancreatic neuroendocrine tumor (PanNET) resection, we assessed outcomes in a large cohort of patients with nonmetastatic, surgically resected PanNETs.
Data of patients with PanNETs resected between 1990 and 2017 were retrospectively collected using databases at 3 academic institutions. The National Death Index was queried to determine vital status. Kaplan-Meier analysis was used to estimate recurrence-free survival (RFS) and disease-specific survival (DSS) rates. Variables associated with recurrence and disease-related death were identified through Cox multivariate analyses.
Of 307 patients with PanNET who underwent resection, recurrence occurred in 79 (26%) of patients. For stage I and II disease, 5-year RFS rates were 90% and 43%, whereas 5-year DSS rates were 98% and 86% (P < 0.0001 and P = 0.0038, respectively). For grades 1, 2, and 3 disease, 5-year RFS rates were 87%, 49%, and 18%, and 5-year DSS rates were 98%, 89%, and 51% (P < 0.0001 for both). Stage II, grade 2, and grade 3 disease were each associated with increased recurrence and disease-specific death.
Stage and grade are important prognostic factors that should be utilized to tailor postsurgical surveillance after curative resection of PanNET.
鉴于胰腺神经内分泌肿瘤（PanNET）切除术后缺乏监测指南共识，我们评估了大量非转移性、手术切除的 PanNET 患者的结局。
使用 3 家学术机构的数据库回顾性收集了 1990 年至 2017 年间接受 PanNET 切除术的患者数据。通过国家死亡索引查询确定生存状态。使用 Kaplan-Meier 分析评估无复发生存（RFS）和疾病特异性生存（DSS）率。通过 Cox 多变量分析确定与复发和疾病相关死亡相关的变量。
在接受切除术的 307 例 PanNET 患者中，79 例（26%）发生了复发。对于 I 期和 II 期疾病，5 年 RFS 率分别为 90%和 43%，而 5 年 DSS 率分别为 98%和 86%（P<0.0001 和 P=0.0038）。对于 1 级、2 级和 3 级疾病，5 年 RFS 率分别为 87%、49%和 18%，5 年 DSS 率分别为 98%、89%和 51%（均 P<0.0001）。II 期、2 级和 3 级疾病均与复发和疾病特异性死亡风险增加相关。
分期和分级是重要的预后因素，应在 PanNET 根治性切除术后的术后监测中加以利用。
