Surgical Strategies And Prognosis Of Malignant Pancreatic Neuroendocrine Tumors

Objective To investigate the clinical characteristics, pathological features, surgical strategies,and prognostic factors of malignant pancreatic neuroendocrine tumors.Methods The medical records of 42 patients with malignant pancreatic neuroendocrine tumors who underwent curative surgery at the Department of General Surgery from January 1995 to January 2013 were analyzed retrospectively. The data included age, sex, symptoms, clinical characteristics, surgical strategies, pathological features and prognosis. According to the extent of surgical resection, the 42 patients were divided into 2 groups, i.e. the extended resection group(n=13) and the non-extended resectio n group(n=29). Categorical variables were compared using c2 test or Fisher ’s exact test, continuous variables were compared using T test. Kaplan-Meier method was adopted for survival analysis and univariate analysis. The difference of survival rates between the 2 groups was evaluated by Log-rank test.Results Among the 42 patients, 21 of whom were females(50%), and 21 were males(50%). The median age was 48.5 years(range from 28 to 72 years). 23 tumors(55%) were located in the head(including neck and uncinatus), and 19 tumors(45%) were located in the body or tail of the pancreas. There was no significant difference between the 2 groups, with regard to the rate of postoperative complications and hospital stay(P>0.05; P>0.05 respectively). The extended resection group had similar overall survival and disease- free survival to the non-extended resection group(P>0.05; P>0.05 respectively). Furthermore, among 37 patients with malignant non- functioning pancreatic neuroendocrine tumors, the extended resection group also had similar overall survival and disease- free survival to the non-extended resection group(P>0.05; P>0.05 respectively).Conclusion For malignant advanced pancreatic neuroendocrine tumors with peripancreatic invasion or distant liver metastases, aggressive extended resection is a safe, feasible, and reasonable choice.