Surgery Versus Surveillance for Well-Differentiated, Nonfunctional Pancreatic Neuroendocrine Tumors: An 11-Year Analysis of the National Cancer Database
| Autor: | Pamela L. Kunz, Hussein A. Assi, Sarbajit Mukherjee, Vipul Pareek, Michael Machiorlatti, Sara K. Vesely, Hassan Hatoum |
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| Rok vydání: | 2019 |
| Předmět: |
Cancer Research
Databases Factual 030230 surgery Neuroendocrine tumors computer.software_genre law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Surgical oncology Gastrointestinal Cancer Medicine Humans Prospective Studies Stage (cooking) Proportional Hazards Models Database business.industry Hazard ratio Cancer medicine.disease Primary tumor Pancreatic Neoplasms Neuroendocrine Tumors Oncology 030220 oncology & carcinogenesis Localized disease business computer |
| Zdroj: | The oncologist. 25(2) |
| ISSN: | 1549-490X |
| Popis: | BACKGROUND: Pancreatic neuroendocrine tumors (panNETs) are a rare group of tumors that make up 2%–3% of pancreatic tumors. Recommended treatment for panNETs generally consists of resection for symptomatic or large asymptomatic tumors; however, optimal management for localized disease is still controversial, with conflicting recommendations in established guidelines. Our study aim is to compare surgical intervention versus active surveillance in nonmetastatic panNETs by size of primary tumor. MATERIALS AND METHODS: Using the National Cancer Database, we identified 2,004 patients diagnosed with localized well‐differentiated, nonfunctional panNETs (NF‐panNETs) between 2004 and 2015. Patients’ clinicopathologic characteristics, treatment modalities, and overall survival (OS) were analyzed using frequency statistics, chi‐square, and Kaplan‐Meier curves. The objective of the study is to assess the outcome of surgical resection versus nonoperative management in patients with panNETs with different tumor sizes. RESULTS: Tumor sizes were divided into three categories: 2 cm. The number of patients with tumor size 2 cm was 220 (11%), 794 (39.6%), and 990 (49.4%), respectively. Overall, 1,781 underwent surgical resection, whereas 223 patients did not. Median follow‐up was 25.9 months. After adjusting for covariates, surgical resection was associated with improved OS in patients with tumor size 1–2 cm (hazard ratio [HR] = 0.37) and >2c m (HR = 0.30) but not |
| Databáze: | OpenAIRE |
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