| Objective To investigate the clinical characteristics and incidence of PNEN with liver metastasis,and to analyze the prognostic factors of PNEN with liver metastasis.Methods The medical records of 25 patients with PNEN with liver metastasis with definite pathological results from May 2001 to December 2015 in Sir Run Run Shaw Hospital,School of medicine,Zhejiang University were retrospectively reviewed.Data of 856 PNENs with liver metastasis with definite pathological results between 2010 and 2013 were also selected from SEER.The clinical characteristics and incidence of PNENs with liver metastasis were analyzed.Prognostic factors of PNENs with liver metastasis were analyzed by using Kaplan-Meier method and univariate and multivariate Cox regression analysis.Results 25 patients from Sir Run Run Shaw Hospital with a mean age of 54.8±8.6 years.12(48.0%)ones were male and 13(52.0%)ones were female.All patients have non-functional tumors.6(24.0%)、16(64.0%)and 3(12.0%)primary tumors were located in head、body or tail and other parts of pancreas,respectively.6(24.0%)tumor sizes were between 2 centimeter(cm)and 4cm.10(40.0%)tumor sizes were more than 4cm.9(36.0%)tumor sizes were unknown.According to differentiation condition,G2 and uncertain tumors were 6(24.0%)and 19(76.0%).The stage of all tumors with liver metastasis were Ⅳ.There were 11(44.0%)cases with lymph node metastasis and 14(56.0%)cases without it.Partial pancreatectomy was performed in 6(24.0%)patients and 1(4.0%)patient had Whipple.Another 18(72.0%)patients had no surgery.There was 1(4.0%)case with only primary tumor surgery and 6(24.0%)cases with both primary and distant tumor surgery.856 patients were from SEER with a mean age of 61.5±13.8 years.485(56.7%)ones were male and 371(43.3%)ones were female.684(79.9%)、111(13.0%)、54(6.3%).7(0.9%)patients were white、black、Asian or Pacific Islander and other races,respectively.815(95.2%)patients had non-functional tumors and 41(4.8%)patients had functional ones.211(24.6%)、379(44.3%)、83(9.8%)primary tumors were located in head、body or tail and other parts of pancreas,respectively.183(21.4%)ones had no information about tumor location.49(5.7%)tumor sizes were less than 2cm.255(29.8%)ones were between 2 cm and 4cm.363(42.4%)ones were more than 4cm.189(22.1%)ones were unknown.G1、G2、G3 and uncertain tumors were 167(19.5%)、81(9.5%)、98(11.4%)and 510(59.6%),respectively.All cases were in stage Ⅳ.There were 283(33.1%)cases with lymph node metastasis and 406(47.4%)cases without it.The information of 167(19.5%)ones was unknown.Partial pancreatectomy、total pancreatectomy、extended pancreatectomy、Whipple、pancreatectomy not specified、surgery not specified were performed in 98(11.4%)、16(1.9%)、3(0.4%)、27(3.2%)、3(0.4%)and 4(0.5%)、respectively.702(82.0%)ones had no surgery and 3(0.4%)ones’ information is unknown.There was 60(7.0%)case with only primary tumor surgery and 91(10.6%)cases with both primary and distant tumor surgery.The incidence of PNEN with liver metastasis per 1000000 was calculated based on data from SEER.The total incidence between 2010 to 2013 was 2.3.The incidence of 2010、2011、2012、2013 was 2.1、2.3、2.4、2.5,respectively.The incidence of age group of 10-19、20-29、30-39、40-49、50-59、60-69、70-79 and more than 80 years old was 0.0、0.2、0.9、2.2、4.3、7.1、10.2 and 6.3,respectively.The incidence of race of white、black and Asian was 2.4、2.8、1.5,respectively.Apart from patients with unknown information,254 patients were included for the prognostic analysis of PNEN with liver metastasis.1、2、3-year OS rates were 53.1%、28.7%、11.4%.DSS rates were 40.9%、18.2%.1.5%for 1、2、3 years.According to Kaplan-Meier method、univariate and multivariate Cox regression analysis,age、grade and surgery were related with OS.It was found that grade、functional status and surgery had relationship with DSS using the Kaplan-Meier method.In the univariate Cox regression analysis,grade and functional status were prognostic factors for DSS.Grade was prognostic factor for DSS using the multivariate Cox regression analysis.Conclusion The overall incidence of PNEN with liver metastasis is 2.3 per 1000000.Male is 2.8 per 1000000 and female is 1.9 per 1000000.There is no obvious difference about the incidence from 2010 to 2013.The incidence increases with age,which is highest between 70 to 79.The black one is most likely to have the disease among all races.Age、grade and surgery are effective in predicting OS.Ageing patients and high grade indicate poor prognosis.Surgery is positive related with OS.Grade has negative relationship with DSS. |
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