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 26 May 2018

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News

Resection of pancreatic neuroendocrine cancer is increasing

Increasing numbers of pancreatic neuroendocrine neoplasms are being resected, due to incidental detection, reports the most recent Archives of Surgery.

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Dr Parsia Vagefi and colleagues from Massachusetts assessed changing patterns in the detection and outcomes of pancreatic neuroendocrine neoplasms.

The investigative team evaluated 168 patients, of which 51% were male with a mean age of 56 years.

The patients underwent surgery for histologically confirmed pancreatic neuroendocrine neoplasms.

The team assessed surgical outcomes, survival, and changes in presentation of pancreatic neuroendocrine neoplasms in 2 groups at different times.

The first group of 77 patients presented with pancreatic neuroendocrine neoplasms between 1977 and 1999.

The second group spanned from 2000 to 2005 and included 91 patients.

58% had nonfunctioning pancreatic neuroendocrine neoplasms
Archives of Surgery

The team found that 58% of patients had nonfunctioning pancreatic neuroendocrine neoplasms, most of which were incidental.

The investigators observed that insulinomas were the most common type of functional neoplasm, followed by gastrinomas and glucagonomas.

The investigative team noted that 7% patients had multiple endocrine neoplasia type 1.

Of the neoplasms, 64% were located in the pancreatic body or tail.

The team noted that pancreaticoduodenectomy was performed in 22% of patients.

The team found that distal pancreatectomy was undertaken in 52%, and the rest had either middle segment pancreatectomy or enucleation.

There were no operative deaths.

The investigative team classified 77% of neoplasms as benign.

Of those classified as malignant, 26% had liver metastases.

The investigators found that 10% of the patients received adjuvant therapy.

Complete follow up was available in 91% of patients.

The investigators observed that the 5 - and 10-year actuarial survival rates were 77% and 62%, respectively.

The team discovered that nonfunctioning neoplasms were significantly more frequent in the last 5 years.

There was a trend toward smaller neoplasms, and lesser likelihood of malignancy.

Dr Vagefi's team commented, “Increasing numbers of pancreatic neuroendocrine neoplasms are being resected, largely owing to the incidental detection of nonfunctioning neoplasms.”

“This may lead to the treatment of smaller and less malignant neoplasms.”

Arch Surg 2007: 142(4): 347-54
19 April 2007

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