Prognosis after curative resection of non-metastatic pancreatic neuroendocrine tumors: a retrospective tertiary center study

Abstract

Background Pancreatic neuroendocrine tumors (pNETs) are rare tumors with heterogeneous outcomes. The aim of our study was to determine the long-term outcome, recurrence patterns, as well as the clinical and pathological factors that impact time-to-recurrence (TTR), recurrence-free survival (RFS), and overall survival (OS) in pNETs treated with curative surgery.

Methods Data for all patients who underwent radical surgery with curative intent for nonmetastatic pNETs were obtained from a prospectively maintained database of the University Hospitals Leuven. Data from September 2002 until November 2021 were analyzed retrospectively. Patients with metastatic disease and/or neuro-endocrine carcinoma were excluded. Median follow-up time was calculated using the reverse Kaplan-Meier method. A Cox proportional hazards model was used to assess variables associated with recurrence.

Results The study included 128 patients. Only 8 patients (6.3%) had recurrent disease over a median follow up of 44.4 months (interquartile range [IQR] 29.8-74.7). The median TTR was 38.7 months (IQR 18.0-46.2). Univariate analysis showed that multiple endocrine neoplasia type 1 (MEN-1) and R1-status were statistically significant predictors for disease recurrence.

Conclusions In our series of patients treated with surgery for non-metastatic, well-differentiated pNETs, recurrence was low at 6.3%. MEN-1 and R1-status were predictors for recurrence in univariate analysis.

Keywords Neuroendocrine tumors, pancreatic neuroendocrine tumors, surgery, prognostic factors

Ann Gastroenterol 2024; 37 (6): 758-764