Yonsei Med J.  2012 Sep;53(5):944-951.

Prognostic Factors and Characteristics of Pancreatic Neuroendocrine Tumors: Single Center Experience

• Oh TG
• Chung MJ
• Park JY
• Bang SM
• Park SW
• Chung JB
• Song SY

Abstract

PURPOSE
Pancreatic neuroendocrine tumors (PNET) are a rare subgroup of tumors. For PNETs, the predictive factors for survival and prognosis are not well known. The purpose of our study was to evaluate the predictive factors for survival and disease progression in PNETs.
MATERIALS AND METHODS
We retrospectively analyzed 37 patients who were diagnosed with PNET at Severance Hospital between November 2005 and March 2010. Prognostic factors for survival and disease progression were evaluated using the Kaplan-Meier method.
RESULTS
The mean age of the patients was 50.0+/-15.0 years. Eight cases (21.6%) were described as functioning tumors and 29 cases (78.4%) as non-functioning tumors. In univariate analysis of clinical factors, patients with liver metastasis (p=0.002), without resection of primary tumors (p=0.002), or American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) stage III/IV (p=0.002) were more likely to demonstrate shorter overall survival (OS). Patients with bile duct or pancreatic duct invasion (p=0.031), sized-lesions larger than 20 mm (p=0.036), liver metastasis (p=0.020), distant metastasis (p=0.005), lymph node metastasis (p=0.009) or without resection of primary tumors (p=0.020) were more likely to demonstrate shorter progression-free survival (PFS). In multivariate analysis of clinical factors, bile duct or pancreatic duct invasion [p=0.010, hazard ratio (HR)=95.046] and tumor location (non-head of pancreas) (p=0.036, HR=7.381) were confirmed as independent factors for predicting shorter PFS.
CONCLUSION
Patients with liver metastasis or without resection of primary tumors were more likely to demonstrate shorter OS. Patients with bile duct or pancreatic duct invasion or tumors located at body or tail of pancreas were more likely to demonstrate shorter PFS.

Keyword

Pancreatic neuroendocrine tumor; prognostic factor; liver metastasis; bile duct invasion; pancreatic duct invasion; location of tumor

MeSH Terms

Bile Ducts
Disease Progression
Disease-Free Survival
Humans
Joints
Liver
Lymph Nodes
Methods
Multivariate Analysis
Neoplasm Metastasis
Neuroectodermal Tumors, Primitive
Neuroendocrine Tumors*
Pancreas
Pancreatic Ducts
Prognosis
Retrospective Studies
Tail

Figure

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  Fig. 1 Evidence of bile or pancreatic duct invasion, confirmed by cholangiography (A), CT (B), magnetic resonance cholangio pancreatography (C), and pathologic findings (D).

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  Fig. 2 (A) Disease-specific survival comparing patients with liver metastasis and those without liver metastasis (p=0.002, univariate analysis). (B) Disease-specific survival comparing patients who underwent definitive resection of the primary tumor and those who did not (p=0.002, univariate analysis).

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  Fig. 3 (A) Disease-specific recurrence or progression comparing patients with duct invasion and those without duct invasion [p=0.010, HR=95.046 (3.857-2341.986), multivariate analysis]. (B) Disease-specific recurrence or progression comparing patients with tumors in the head of pancreas and those not within the head of the pancreas [p=0.036, HR=7.381 (1.143-47.652), multivariate analysis].

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