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Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study.

Publication ,  Journal Article
Sadot, E; Reidy-Lagunes, DL; Tang, LH; Do, RKG; Gonen, M; D'Angelica, MI; DeMatteo, RP; Kingham, TP; Groot Koerkamp, B; Untch, BR; Brennan, MF ...
Published in: Ann Surg Oncol
April 2016

OBJECTIVE: To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain. METHODS: Incidentally discovered, sporadic, small (<3 cm), stage I-II PanNET were analyzed retrospectively between 1993 and 2013. Diagnosis was determined either by pathology or imaging characteristics. Intention-to-treat analysis was applied. RESULTS: A total of 464 patients were reviewed. Observation was recommended for 104 patients (observation group), and these patients were matched to 77 patients in the resection group based on tumor size at initial imaging. The observation group was significantly older (median 63 vs. 59 years, p = 0.04) and tended towards shorter follow-up (44 vs. 57 months, p = 0.06). Within the observation group, 26 of the 104 patients (25 %) underwent subsequent tumor resection after a median observation interval of 30 months (range 7-135). At the time of last follow-up of the observation group, the median tumor size had not changed (1.2 cm, p = 0.7), and no patient had developed evidence of metastases. Within the resection group, low-grade (G1) pathology was recorded in 72 (95 %) tumors and 5 (6 %) developed a recurrence, which occurred after a median of 5.1 (range 2.9-8.1) years. No patient in either group died from disease. Death from other causes occurred in 11 of 181 (6 %) patients. CONCLUSIONS: In this study, no patient who was initially observed developed metastases or died from disease after a median follow-up of 44 months. Observation for stable, small, incidentally discovered PanNET is reasonable in selected patients.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

April 2016

Volume

23

Issue

4

Start / End Page

1361 / 1370

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Patient Selection
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neuroendocrine Tumors
  • Neoplasm Staging
  • Middle Aged
 

Citation

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Sadot, E., Reidy-Lagunes, D. L., Tang, L. H., Do, R. K. G., Gonen, M., D’Angelica, M. I., … Allen, P. J. (2016). Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study. Ann Surg Oncol, 23(4), 1361–1370. https://doi.org/10.1245/s10434-015-4986-1
Sadot, Eran, Diane L. Reidy-Lagunes, Laura H. Tang, Richard Kinh Gian Do, Mithat Gonen, Michael I. D’Angelica, Ronald P. DeMatteo, et al. “Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study.Ann Surg Oncol 23, no. 4 (April 2016): 1361–70. https://doi.org/10.1245/s10434-015-4986-1.
Sadot E, Reidy-Lagunes DL, Tang LH, Do RKG, Gonen M, D’Angelica MI, et al. Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study. Ann Surg Oncol. 2016 Apr;23(4):1361–70.
Sadot, Eran, et al. “Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study.Ann Surg Oncol, vol. 23, no. 4, Apr. 2016, pp. 1361–70. Pubmed, doi:10.1245/s10434-015-4986-1.
Sadot E, Reidy-Lagunes DL, Tang LH, Do RKG, Gonen M, D’Angelica MI, DeMatteo RP, Kingham TP, Groot Koerkamp B, Untch BR, Brennan MF, Jarnagin WR, Allen PJ. Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case-Control Study. Ann Surg Oncol. 2016 Apr;23(4):1361–1370.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

April 2016

Volume

23

Issue

4

Start / End Page

1361 / 1370

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Patient Selection
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neuroendocrine Tumors
  • Neoplasm Staging
  • Middle Aged