Recurrence-Free Survival and Disease-Specific Survival in Patients with Pancreatic Neuroendocrine Neoplasms: A Single-Center Retrospective Study of 413 Patients.

Autor: Møller S; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Langer SW; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Oncology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, 1172 Copenhagen, Denmark., Slott C; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Krogh J; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, 1172 Copenhagen, Denmark., Hansen CP; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Kjaer A; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Biomedical Sciences, University of Copenhagen, 1172 Copenhagen, Denmark., Holmager P; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Klose M; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Garbyal RS; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Pathology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Knigge U; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Surgery and Transplantation, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark., Andreassen M; ENETS Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Endocrinology and Metabolism 7562, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, 1172 Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Dec 24; Vol. 16 (1). Date of Electronic Publication: 2023 Dec 24.
DOI: 10.3390/cancers16010100
Abstrakt: Introduction: The prognosis and impact of different prognostic factors in pancreatic neuroendocrine neoplasms (pNEN) remain controversial.
Aim: To investigate prognostic factors for recurrence-free survival and disease-specific survival in patients with pNEN, divided into three groups: patients undergoing surveillance (tumor size < 2 cm, group 1), patients followed after curative-intended surgery (group 2), and patients with unresectable disease or residual tumors after resection (group 3).
Method: A single-center retrospective study including consecutive patients over a 20-year period. Multivariate Cox regression analyses were performed to identify risk factors.
Results: 413 patients were included, with a mean (SD) age of 62 ± 14 years. In group 1 (n = 51), median (IQR) follow-up was 29 (21-34) months, and tumor size was 1.0 (0.8-1.4) cm. One progressed and had a tumor resection. In group 2 (n = 165), follow-up 59 (31-102) months, median tumor size 2 (1.2-3.4) cm, median Ki-67 index 5 (3-10)%, the 5-year recurrence rate was 21%. Tumor size ( p < 0.001), Ki-67 index ( p = 0.02), and location in the pancreatic head ( p < 0.001) were independent risk factors. In group 3 (n = 197), follow-up 19 (6-46) months, median tumor size 4.2 (2.6-7.0) cm, Ki-67 index 17 (9-64)%, the median disease-specific survival was 22 (6-75) months-99 in NET G1; 54 in NET G2; 14 in NET G3; and 6 months in neuroendocrine carcinomas (NEC). Age ( p = 0.029), plasma chromogranin A ( p = 0.014), and proliferation, expressed by grade ( p = 0.001) and Ki-67 index ( p < 0.001), were risk factors.
Conclusion: Growth in pNET < 2 cm requiring surgery was observed in 1/51. Tumor size, Ki-67 index, and location in the head were prognostic factors for disease recurrence, while age, plasma chromogranin A, and proliferation predicted mortality in patients with unresectable disease or residual tumors after resection.
Databáze: MEDLINE
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