Journal of Gastrointestinal Surgery

, Volume 11, Issue 11, pp 1460–1469 | Cite as

Clinicopathologic Features and Treatment Trends of Pancreatic Neuroendocrine Tumors: Analysis of 9,821 Patients

  • Karl Y. Bilimoria
  • James S. Tomlinson
  • Ryan P. Merkow
  • Andrew K. Stewart
  • Clifford Y. Ko
  • Mark S. Talamonti
  • David J. BentremEmail author


The natural history of pancreatic neuroendocrine tumors (PNET) remains poorly defined. Our objectives were to examine the clinicopathologic features of PNETs, to assess treatment trends over time, and to identify factors associated with undergoing resection. From the National Cancer Data Base (1985–2004), 9,821 patients were identified with PNETs. Clinicopathologic features and treatment trends were examined. Multivariable logistic regression was used to assess factors associated with undergoing resection. Of 9,821 patients with PNETs, 85% were nonfunctional, 7.1% were functional, and 7.9% were carcinoid tumors. Of the 3,851 (39.0%) patients who underwent pancreatectomy, 449 (11.7%) received adjuvant chemotherapy, and 254 (6.6%) received adjuvant radiation. From 1985 to 2004, utilization of pancreatectomy increased from 39.4 to 44.3% (P < 0.0001). Patients were less likely to undergo resection if they were >55 years old, had tumors in the head of the pancreas, tumors ≥4 cm, or had distant metastases (P < 0.0001). Patients treated at NCCN/NCI, academic, or high-volume hospitals were more likely to undergo resection. There are disparities in the utilization of pancreatectomy for PNETs. As PNETs have a better prognosis than adenocarcinoma, concerns regarding the morbidity and mortality of pancreatic surgery and neoplasms should not preclude resection.


Pancreatic neuroendocrine tumors Surgery Pancreatectomy National Cancer Data Base 



KYB is supported by the American College of Surgeons, Clinical Scholars in Residence program and a research grant from the Department of Surgery, Feinberg School of Medicine, Northwestern University. This study was presented in part at the 48th Annual Meeting of the Society for Surgery of the Alimentary Tract (SSAT) meeting at Digestive Disease Week 2007 in Washington, DC on May 23, 2007.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2007

Authors and Affiliations

  • Karl Y. Bilimoria
    • 1
    • 2
  • James S. Tomlinson
    • 3
  • Ryan P. Merkow
    • 1
  • Andrew K. Stewart
    • 2
  • Clifford Y. Ko
    • 2
    • 3
  • Mark S. Talamonti
    • 1
  • David J. Bentrem
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of Surgery, Northwestern Memorial HospitalNorthwestern University, Feinberg School of MedicineChicagoUSA
  2. 2.Cancer ProgramsAmerican College of SurgeonsChicagoUSA
  3. 3.Department of SurgeryUniversity of California, Los Angeles (UCLA) and VA Greater Los Angeles Healthcare SystemLos AngelesUSA

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