Figueira Estela Regina Ramos, Montagnini André Luis, Okubo Jessica, Fernandes Ana Gabriela Vivarelli, Pereira Marina Alessandra, Ribeiro Junior Ulysses, Herman Paulo, Jukemura José
Universidade de São Paulo, Faculty of Medicine - São Paulo (SP), Brazil.
Arq Bras Cir Dig. 2025 Jan 20;37:e1857. doi: 10.1590/0102-6720202400063e1857. eCollection 2025.
Pancreatic neuroendocrine tumors (PNETs) are uncommon and heterogeneous neoplasms, often exhibiting indolent biological behavior. Their incidence is rising, largely due to the widespread use of high-resolution imaging techniques, particularly influencing the diagnosis of sporadic non-functioning tumors, which account for up to 80% of cases. While surgical resection remains the only curative option, the impact of factors such as tumor grade, size, and type on prognosis and recurrence is still unclear.
To investigate prognostic risk factors and outcomes in patients with sporadic PNETs treated surgically.
A retrospective analysis was conducted on patients with sporadic PNETs who underwent pancreatic resection. Data were collected from medical records.
A total of 113 patients were included: 32 with non-functioning tumors (NF-PNETs), 70 with insulinomas, and 11 with other functioning tumors (OF-PNETs). Patients with insulinoma were significantly younger, had a higher BMI, lower prevalence of comorbidities and ASA scores, and underwent significantly more pancreatic enucleations compared to patients with OF-PNET and NF-PNET. The insulinoma group had more grade I tumors, smaller tumor diameter, lower TNM staging, and lower disease recurrence rates. In univariate analysis, age, tumor type, tumor size, and TNM staging were identified as potential risk factors for tumor recurrence. In multivariate analysis, only the NF-PNET type was identified as an independent prognostic factor for disease recurrence.
NF-PNETs are an independent prognostic risk factor for disease recurrence. This finding supports the need for closer follow-up of patients with small tumors who are selected for conservative management.
胰腺神经内分泌肿瘤(PNETs)是罕见的异质性肿瘤,通常表现出惰性生物学行为。其发病率正在上升,主要归因于高分辨率成像技术的广泛应用,尤其影响了散发性无功能肿瘤的诊断,此类肿瘤占病例的80%。虽然手术切除仍然是唯一的治愈选择,但肿瘤分级、大小和类型等因素对预后和复发的影响仍不明确。
研究手术治疗的散发性PNETs患者的预后危险因素及结局。
对接受胰腺切除术的散发性PNETs患者进行回顾性分析。数据从病历中收集。
共纳入113例患者:32例为无功能肿瘤(NF-PNETs),70例为胰岛素瘤,11例为其他有功能肿瘤(OF-PNETs)。与OF-PNET和NF-PNET患者相比,胰岛素瘤患者明显更年轻,BMI更高,合并症患病率和ASA评分更低,且接受胰腺剜除术的比例明显更高。胰岛素瘤组I级肿瘤更多,肿瘤直径更小,TNM分期更低,疾病复发率更低。单因素分析中,年龄、肿瘤类型、肿瘤大小和TNM分期被确定为肿瘤复发的潜在危险因素。多因素分析中,仅NF-PNET类型被确定为疾病复发的独立预后因素。
NF-PNETs是疾病复发的独立预后危险因素。这一发现支持对选择保守治疗的小肿瘤患者进行密切随访的必要性。