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Surgical Treatment as a Principle for Patients with High-Grade Pancreatic Neuroendocrine Carcinoma: A Nordic Multicenter Comparative Study

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the role of surgery for patients with high-grade pancreatic neuroendocrine carcinoma (hgPNEC) in a large Nordic multicenter cohort study. Prior studies evaluating the role of surgery for patients with hgPNEC are limited, and the benefit of the surgery is uncertain.

Methods

Data from patients with a diagnosis of hgPNEC determined between 1998 and 2012 were retrospectively registered at 10 Nordic university hospitals. Kaplan–Meier curves were used to compare the overall survival of different treatment groups, and Cox-regression analysis was used to evaluate factors potentially influencing survival.

Results

The study registered 119 patients. The median survival period from the time of metastasis was 23 months for patients undergoing initial resection of localized nonmetastatic disease and chemotherapy at the time of recurrence (n = 14), 29 months for patients undergoing resection of the primary tumor and resection/radiofrequency ablation of synchronous metastatic liver disease (n = 12), and 13 months for patients with synchronous metastatic disease given systemic chemotherapy alone (n = 78). The 3-year survival rate after surgery of the primary tumor and metastatic disease was 69 %. Resection of the primary tumor was an independent factor for improved survival after occurrence of metastatic disease.

Conclusions

Patients with resected localized nonmetastatic hgPNEC and later metastatic disease seemed to benefit from initial resection of the primary tumor. Patients selected for resection of the primary tumor and synchronous liver metastases had a high 3-year survival rate. Selected patients with both localized hgPNEC and metastatic hgPNEC should be considered for radical surgical treatment.

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Acknowledgment

The study was initiated by the Nordic Neuroendocrine Tumor Group. We thank Randi Eikeland (Clinical Cancer Research Office, Haukeland University Hospital, Bergen, Norway) for assisting with data management. The study was supported by grants from the Nordic Cancer Union and Eckbo Foundations. Halfdan Sorbye received funding from the Norwegian Cancer Society; Eva Tiensuu Janson received a research grant from the Swedish Cancer Society; and Henning Grønbæk received a clinical research grant from the Novo Nordisk Foundation.

Disclosure

There are no conflicts of interest.

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Authors and Affiliations

  1. Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway

    Sven-Petter Haugvik MD, Knut Jørgen Labori MD, PhD & Ivar Prydz Gladhaug MD, PhD

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Sven-Petter Haugvik MD & Ivar Prydz Gladhaug MD, PhD

  3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden

    Eva Tiensuu Janson MD, PhD

  4. Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland

    Pia Österlund MD, PhD

  5. Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Seppo W. Langer MD, PhD

  6. Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway

    Ragnhild Sørum Falk PhD

  7. Department of Oncology, Odense University Hospital, Odense C, Denmark

    Lene Weber Vestermark MD, PhD

  8. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark

    Henning Grønbæk MD, PhD

  9. Department of Oncology, Haukeland University Hospital, Bergen, Norway

    Halfdan Sorbye MD, PhD

Authors
  1. Sven-Petter Haugvik MD
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  2. Eva Tiensuu Janson MD, PhD
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  3. Pia Österlund MD, PhD
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  4. Seppo W. Langer MD, PhD
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  5. Ragnhild Sørum Falk PhD
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  6. Knut Jørgen Labori MD, PhD
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  7. Lene Weber Vestermark MD, PhD
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  8. Henning Grønbæk MD, PhD
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  10. Halfdan Sorbye MD, PhD
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Corresponding author

Correspondence to Sven-Petter Haugvik MD.

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Haugvik, SP., Janson, E.T., Österlund, P. et al. Surgical Treatment as a Principle for Patients with High-Grade Pancreatic Neuroendocrine Carcinoma: A Nordic Multicenter Comparative Study. Ann Surg Oncol 23, 1721–1728 (2016). https://doi.org/10.1245/s10434-015-5013-2

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  • DOI: https://doi.org/10.1245/s10434-015-5013-2

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