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Journal of Gastrointestinal Surgery

, Volume 14, Issue 5, pp 891–898 | Cite as

Surgery and Staging of Pancreatic Neuroendocrine Tumors: A 14-Year Experience

  • Hiromichi Ito
  • Michael Abramson
  • Kaori Ito
  • Edward Swanson
  • Nancy Cho
  • Daniel T. Ruan
  • Richard S. Swanson
  • Edward E. WhangEmail author
Original Article

Abstract

Background

The aims of this study were to evaluate contemporary outcomes associated with the surgical management of pancreatic neuroendocrine tumors (PNETs) and to assess the prognostic value of the World Health Organization (WHO) classification and TNM staging for PNETs.

Methods

The medical records of 73 consecutive patients with PNETs treated at a single institution from January 1992 through September 2006 were reviewed. Survival was analyzed with the Kaplan-Meier method (median follow-up: 43 months).

Results

Median patient age was 52 years (range, 19-83 years), and 36 (49%) patients were male. Thirty-three patients had a well-differentiated neuroendocrine tumor (WDT), 26 had a well-differentiated neuroendocrine carcinoma (WDCa), and 14 had a poorly differentiated neuroendocrine carcinoma (PDCa). Fifty (68%) patients underwent potentially curative resection, and the 5-year disease-specific survival (DSS) rate for the entire cohort was 62%. WHO classification and TNM staging system provided good prognostic stratification of patients; 5-year DSS rates were 100% for WDT, 57% for WDCa, 8% for PDCa, respectively, by WHO classification (p < 0.001), and 100% for stage 1, 90% for stage 2, 57% for stage 3, and 8% for stage 4, respectively, by TNM stage (p < 0.001). Among the patients who underwent potentially curative resection, nodal status, distant metastasis, and tumor grade were significant prognostic factors.

Conclusion

WHO classification and TNM staging are useful for prognostic stratification among patients with PNETs.

Keywords

Pancreatic neuroendocrine tumor Surgery Staging 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Hiromichi Ito
    • 1
  • Michael Abramson
    • 1
  • Kaori Ito
    • 1
  • Edward Swanson
    • 1
  • Nancy Cho
    • 1
  • Daniel T. Ruan
    • 1
  • Richard S. Swanson
    • 1
  • Edward E. Whang
    • 1
    Email author
  1. 1.Department of SurgeryBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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