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Head and body/tail pancreatic neuroendocrine tumors have different biological characteristics and clinical outcomes

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

The incidence of pancreatic neuroendocrine tumors (pNETs) has continued to increase, but for pNETs, there is still no distinction between treatments based on anatomical location. We aim to determine whether NETs located at the head and body/tail of the pancreas are different.

Patients and methods

Within the Surveillance, Epidemiology, and End Results database (2004–2016), we focused on pNETs patients with comprehensive information. The patients were divided into two groups based on tumors’ location. We compared the characteristics of the two groups and assessed the risk factors for lymphatic metastasis. Survival analysis was performed based on the biological characteristics of the tumor.

Results

In all 3011 patients, pNETs were more common in the body/tail (62.94%) than in the head (37.06%) of the pancreas. The risk factors for lymph node metastasis in the two groups were different. Nonmetastatic, low-grade pancreatic body/tail NETs had the best prognosis (p < 0.001). For low-grade tumors (G1–G2), lymphatic metastasis did not significantly affect the prognosis of patients with pancreatic head NETs (p = 0.098) but affected the overall survival of patients with pancreatic body/tail NETs (p < 0.001). The tumors at the pancreatic head were larger (p = 0.001), more likely to have positive lymph nodes (p < 0.001) and more prone to locally advanced and distant invasion (p < 0.001). The prognosis of pancreatic head NETs 21–40 mm was worse than that of body/tail pNETs (p < 0.001). For non-functional NETs, the overall survival of pancreatic body/tail tumors was better (p < 0.001).

Conclusion

The pancreatic head and pancreatic body/tail NETs have different biological characteristics and clinical outcomes and they should be treated differently.

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Acknowledgements

The research team thanks the SEER database for the detailed and accurate data. Thank you to Mo Cheng and Yuze Wang for their disinterested support and help.

Funding

The research was supported by Beijing Municipal Science & Technology Commission, No. Z171100001017077.

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Authors and Affiliations

  1. Department of General Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, China

    Wentong Mei, Yixuan Ding, Shuo Wang, Yuchen Jia, Feng Cao & Fei Li

  2. Clinical Center for Acute Pancreatitis, Capital Medical University, Beijing, China

    Wentong Mei, Yixuan Ding, Shuo Wang, Yuchen Jia, Feng Cao & Fei Li

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  1. Wentong Mei
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  2. Yixuan Ding
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  3. Shuo Wang
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  4. Yuchen Jia
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  5. Feng Cao
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  6. Fei Li
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Contributions

WM designed this research, completed the data analysis statistics work and wrote the manuscript; YD worked in data collection and analysis; SW assisted in completing statistical work; YJ drew and modified the tables and charts; FC and FL guided all research work, revised research plans, reviewed the manuscripts and provided financial support.

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Correspondence to Feng Cao or Fei Li.

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Mei, W., Ding, Y., Wang, S. et al. Head and body/tail pancreatic neuroendocrine tumors have different biological characteristics and clinical outcomes. J Cancer Res Clin Oncol 146, 3049–3061 (2020). https://doi.org/10.1007/s00432-020-03303-w

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  • DOI: https://doi.org/10.1007/s00432-020-03303-w

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