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Annals of Surgical Oncology

, Volume 26, Issue 5, pp 1385–1393 | Cite as

Surgery for Pancreatic Neuroendocrine Tumor G3 and Carcinoma G3 Should be Considered Separately

  • Tsukasa Yoshida
  • Susumu HijiokaEmail author
  • Waki Hosoda
  • Makoto Ueno
  • Masayuki Furukawa
  • Noritoshi Kobayashi
  • Masafumi Ikeda
  • Tetsuhide Ito
  • Yuzo Kodama
  • Chigusa Morizane
  • Kenji Notohara
  • Hiroki Taguchi
  • Masayuki Kitano
  • Kei Yane
  • Yoshiaki Tsuchiya
  • Izumi Komoto
  • Hiroki Tanaka
  • Akihito Tsuji
  • Syunpei Hashigo
  • Tetsuya Mine
  • Atsushi Kanno
  • Go Murohisa
  • Katsuyuki Miyabe
  • Tadayuki Takagi
  • Nobutaka Matayoshi
  • Masafumi Sakaguchi
  • Hiroshi Ishii
  • Yasushi Kojima
  • Keitaro Matsuo
  • Hideyuki Yoshitomi
  • Shoji Nakamori
  • Hiroaki Yanagimoto
  • Yasushi Yatabe
  • Junji Furuse
  • Nobumasa Mizuno
Endocrine Tumors
  • 165 Downloads

Abstract

Background

The role of surgery in pancreatic neuroendocrine neoplasm grade 3 (pNEN-G3) treatment remains unclear. We aimed to clarify the role of surgery for pNEN-G3, which has recently been reclassified as pancreatic neuroendocrine tumor-G3 (pNET-G3) and pancreatic neuroendocrine carcinoma-G3 (pNEC-G3), with and without metastases, respectively.

Methods

We analyzed a subgroup of patients from the Japanese pancreatic NEC study, a Japanese multicenter case-series study of pNEN-G3. Pathologists subclassified 67 patients as having pNET-G3 or pNEC-G3 based on morphological features. We compared the overall survival (OS) rates among patients who were grouped according to whether they had undergone tumor-targeted surgery for tumors without (SwoM) or with (SwM) metastases, or non-surgical procedures (NS).

Results

Data from 21 patients with pNET-G3 (SwoM, n = 6; SwM, n = 5; NS, n = 10) and 46 patients with pNEC-G3 (SwoM, n = 8; SwM, n = 5; NS, n = 33) were analyzed. OS of patients with pNET-G3 was significantly longer after SwoM and SwM than with NS (p = 0.018 and p = 0.022). In contrast, OS did not significantly differ between either SwoM or SwM and NS (p = 0.093 and p = 0.489) among patients with pNEC-G3.

Conclusion

The role of surgery should be considered separately for pNET-G3 and pNEC-G3. Although SwoM and SwM can be considered for pNET-G3, caution is advised before considering SwM and SwoM for pNEC-G3.

Notes

Acknowledgment

This research was supported by the Japan Agency for Medical Research and Development (AMED) under Grant Number JP15ck0106138h0002, and by a Grant from the Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant No. JP26461041). The main analysis of the Japanese pNEC study was reported by Hijioka et al.18

Disclosures

Junji Furuse fully declares any financial or other potential conflicts of interest as follows: honoraria from Taiho, Chugai, Yakult, Sumitomo Dainippon, Eli Lilly Japan, Astellas, Ono, Pfizer, Bayer, Novartis, Merck Serono, Takeda, Eisai, MSD, Shionogi, J-Pharma, Daiichi Sankyo, Mochida, Nippon Kayaku, EA Pharma, Sawai, Teijin Pharma; consulting or advisory role with Taiho, Chugai, Yakult, Sumitomo Dainippon, Eli Lilly Japan, Astellas, Ono, Pfizer, Bayer, Novartis, Merck Serono, Takeda, Eisai, MSD, Shionogi, J-Pharma, Daiichi Sankyo, Kyowa Hakko Kirin, Sanofi, Sandoz, Otsuka, Zeria, Fujifilm, Astra Zeneca, Asahi Kasei, Shire; and research funding from J-Pharma, Taiho, Sumitomo Dainippon, Janssen, Daiichi Sankyo, MSD, Yakult, Takeda, Chugai, Ono, Astellas, Zeria, Novartis, Nanocarrier, Shionogi, Onco Therapy Science, Eli Lilly Japan, Bayer, Bristol-Myers Squibb, Merck Serono, Kyowa Hakko Kirin, Eisai, NanoCarrier, Mochida, Baxalta, and Sanofi. Nobumasa Mizuno fully declares any financial or other potential conflicts of interest as follows: honoraria from Taiho, Novartis, Ono Pharmaceutical, Yakult, and Teijin Pharma; advisory role with Teijin Pharma; and research funding from Taiho, Merck Serono, AstraZeneca, Zeria Pharmaceutical, NanoCarrier, Eisai, MSD, Novartis, Dainippon Sumitomo Pharma, ASLAN Pharmaceuticals, Pharma Valley Center, Incyte Inc., and Yakult. Tsukasa Yoshida, Susumu Hijioka, Waki Hosoda, Makoto Ueno, Masayuki Furukawa, Noritoshi Kobayashi, Masafumi Ikeda, Tetsuhide Ito, Yuzo Kodama, Chigusa Morizane, Kenji Notohara, Hiroki Taguchi, Masayuki Kitano, Kei Yane, Yoshiaki Tsuchiya, Izumi Komoto, Hiroki Tanaka, Akihito Tsuji, Syunpei Hashigo, Tetsuya Mine, Atsushi Kanno, Go Murohisa, Katsuyuki Miyabe, Tadayuki Takagi, Nobutaka Matayoshi, Masafumi Sakaguchi, Hiroshi Ishii, Yasushi Kojima, Keitaro Matsuo, Hideyuki Yoshitomi, Shoji Nakamori, Hiroaki Yanagimoto and Yasushi Yatabe declare they have no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Tsukasa Yoshida
    • 1
    • 2
  • Susumu Hijioka
    • 1
    • 3
    Email author
  • Waki Hosoda
    • 4
    • 5
  • Makoto Ueno
    • 6
  • Masayuki Furukawa
    • 7
  • Noritoshi Kobayashi
    • 8
  • Masafumi Ikeda
    • 9
  • Tetsuhide Ito
    • 10
  • Yuzo Kodama
    • 11
  • Chigusa Morizane
    • 3
  • Kenji Notohara
    • 12
  • Hiroki Taguchi
    • 13
  • Masayuki Kitano
    • 14
  • Kei Yane
    • 15
  • Yoshiaki Tsuchiya
    • 16
  • Izumi Komoto
    • 17
  • Hiroki Tanaka
    • 18
  • Akihito Tsuji
    • 19
  • Syunpei Hashigo
    • 20
  • Tetsuya Mine
    • 21
  • Atsushi Kanno
    • 22
  • Go Murohisa
    • 23
  • Katsuyuki Miyabe
    • 24
  • Tadayuki Takagi
    • 25
  • Nobutaka Matayoshi
    • 26
  • Masafumi Sakaguchi
    • 27
  • Hiroshi Ishii
    • 28
    • 29
  • Yasushi Kojima
    • 30
  • Keitaro Matsuo
    • 31
  • Hideyuki Yoshitomi
    • 32
  • Shoji Nakamori
    • 33
  • Hiroaki Yanagimoto
    • 34
  • Yasushi Yatabe
    • 4
  • Junji Furuse
    • 35
  • Nobumasa Mizuno
    • 1
  1. 1.Department of GastroenterologyAichi Cancer Center HospitalNagoyaJapan
  2. 2.Department of GastroenterologyKizawa Memorial HospitalMinokamoJapan
  3. 3.Department of Hepatobiliary and Pancreatic OncologyNational Cancer Center HospitalTokyoJapan
  4. 4.Department of Pathology and Molecular DiagnosticsAichi Cancer Center HospitalNagoyaJapan
  5. 5.Department of PathologyThe Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of MedicineBaltimoreUSA
  6. 6.Division of Hepatobiliary and Pancreatic Medical OncologyKanagawa Cancer CenterYokohamaJapan
  7. 7.Department of Hepato-Biliary-PancreatologyNational Kyushu Cancer CenterFukuokaJapan
  8. 8.Department of OncologyYokohama City University HospitalYokohamaJapan
  9. 9.Department of Hepatobiliary and Pancreatic OncologyNational Cancer Center Hospital EastKashiwaJapan
  10. 10.Department of Medicine and Bioregulatory Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  11. 11.Department of Gastroenterology and Hepatology, Graduate School of MedicineKyoto UniversityKyotoJapan
  12. 12.Department of Anatomic PathologyKurashiki Central HospitalKurashikiJapan
  13. 13.Department of Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
  14. 14.Department of Gastroenterology and HepatologyKinki University, Faculty of MedicineSayamaJapan
  15. 15.Center for Gastroenterology, Teine-Keijinkai HospitalSapporoJapan
  16. 16.Department of Digestive SurgeryNiigata Cancer Center HospitalNiigataJapan
  17. 17.Department of SurgeryKansai Electric Power HospitalOsakaJapan
  18. 18.Department of GastroenterologySuzuka General HospitalSuzukaJapan
  19. 19.Department of Medical OncologyKobe City Medical Center General HospitalKobeJapan
  20. 20.Department of Gastroenterology and Hepatology, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  21. 21.Department of GastroenterologyTokai University School of MedicineIseharaJapan
  22. 22.Division of GastroenterologyTohoku University Graduate School of MedicineSendaiJapan
  23. 23.Department of GastroenterologySeirei Hamamatsu General HospitalHamamatsuJapan
  24. 24.Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
  25. 25.Department of GastroenterologyFukushima Medical University School of MedicineFukushimaJapan
  26. 26.Department of Surgery, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
  27. 27.Department of GastroenterologySaiseikai Kumamoto HospitalKumamotoJapan
  28. 28.Department of GastroenterologyShikoku Cancer CenterMatsuyamaJapan
  29. 29.Department of GastroenterologyCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  30. 30.Department of GastroenterologyCenter Hospital of the National Center for Global Health and MedicineTokyoJapan
  31. 31.Division of Molecular and Clinical EpidemiologyAichi Cancer Center Research InstituteNagoyaJapan
  32. 32.Department of General SurgeryChiba University, Graduate School of MedicineChibaJapan
  33. 33.Department of Hepato-biliary-Pancreatic SurgeryNational Hospital Organization Osaka National HospitalOsakaJapan
  34. 34.Department of SurgeryKansai Medical University HospitalMaikataJapan
  35. 35.Department of Medical OncologyKyorin University Faculty of MedicineMitakaJapan

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