BACKGROUND: Information on malignant pancreatic neuroendocrine neoplasms (pNENs) is mostly from retrospective studies in highly selected patients. The aim of this prospective, multicentre study was to assess treatment and outcomes of malignant pNENs in clinical practice. PATIENTS AND METHODS: Consecutive patients with newly diagnosed, histologically-proven pNENs were included and followed-up for 2 years. Tumours were defined as malignant when nodal or distant metastases were present or invasion of extrapancreatic structures/organs was evident. RESULTS: A total of 140 patients with malignant pNENs were included. Ninety-eight patients (70.0%) underwent a surgical resection (76 radical and 22 palliative). Other non-surgical treatments were used in 101 patients (72.1%): somatostatin analogues (n = 63), chemotherapy (n = 30), ablative treatments (n = 15) and peptide-receptor radionuclide therapy (n = 14). No relationship was observed between the 2010 WHO classification and type of treatment. A surgical resection was more often performed in incidentally detected tumours located in the pancreas body tail. Two-year progression-free survival was 63.8%: 82% after a radical resection, 44% after a palliative resection and 41% without a resection. A radical resection and Ki67 proliferative index >5% and >10% were the only significant prognostic determinants in multivariate analysis. CONCLUSIONS: A radical resection is the cornerstone treatment of malignant pNENs and represents, together with Ki67 assessment, the most powerful prognostic factor for 2-year outcomes.
BACKGROUND: Information on malignant pancreatic neuroendocrine neoplasms (pNENs) is mostly from retrospective studies in highly selected patients. The aim of this prospective, multicentre study was to assess treatment and outcomes of malignant pNENs in clinical practice. PATIENTS AND METHODS: Consecutive patients with newly diagnosed, histologically-proven pNENs were included and followed-up for 2 years. Tumours were defined as malignant when nodal or distant metastases were present or invasion of extrapancreatic structures/organs was evident. RESULTS: A total of 140 patients with malignant pNENs were included. Ninety-eight patients (70.0%) underwent a surgical resection (76 radical and 22 palliative). Other non-surgical treatments were used in 101 patients (72.1%): somatostatin analogues (n = 63), chemotherapy (n = 30), ablative treatments (n = 15) and peptide-receptor radionuclide therapy (n = 14). No relationship was observed between the 2010 WHO classification and type of treatment. A surgical resection was more often performed in incidentally detected tumours located in the pancreas body tail. Two-year progression-free survival was 63.8%: 82% after a radical resection, 44% after a palliative resection and 41% without a resection. A radical resection and Ki67 proliferative index >5% and >10% were the only significant prognostic determinants in multivariate analysis. CONCLUSIONS: A radical resection is the cornerstone treatment of malignant pNENs and represents, together with Ki67 assessment, the most powerful prognostic factor for 2-year outcomes.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: Matthew H Kulke; Lillian L Siu; Joel E Tepper; George Fisher; Deborah Jaffe; Daniel G Haller; Lee M Ellis; Jacqueline K Benedetti; Emily K Bergsland; Timothy J Hobday; Eric Van Cutsem; James Pingpank; Kjell Oberg; Steven J Cohen; Mitchell C Posner; James C Yao Journal: J Clin Oncol Date: 2011-01-24 Impact factor: 44.544
Authors: Eric Raymond; Laetitia Dahan; Jean-Luc Raoul; Yung-Jue Bang; Ivan Borbath; Catherine Lombard-Bohas; Juan Valle; Peter Metrakos; Denis Smith; Aaron Vinik; Jen-Shi Chen; Dieter Hörsch; Pascal Hammel; Bertram Wiedenmann; Eric Van Cutsem; Shem Patyna; Dongrui Ray Lu; Carolyn Blanckmeister; Richard Chao; Philippe Ruszniewski Journal: N Engl J Med Date: 2011-02-10 Impact factor: 91.245
Authors: R Garcia-Carbonero; J Capdevila; G Crespo-Herrero; J A Díaz-Pérez; M P Martínez Del Prado; V Alonso Orduña; I Sevilla-García; C Villabona-Artero; A Beguiristain-Gómez; M Llanos-Muñoz; M Marazuela; C Alvarez-Escola; D Castellano; E Vilar; P Jiménez-Fonseca; A Teulé; J Sastre-Valera; M Benavent-Viñuelas; A Monleon; R Salazar Journal: Ann Oncol Date: 2010-02-05 Impact factor: 32.976
Authors: N C Turner; S J Strauss; D Sarker; R Gillmore; A Kirkwood; A Hackshaw; A Papadopoulou; J Bell; I Kayani; C Toumpanakis; F Grillo; A Mayer; D Hochhauser; R H Begent; M E Caplin; T Meyer Journal: Br J Cancer Date: 2010-03-16 Impact factor: 7.640
Authors: G Rindi; G Klöppel; H Alhman; M Caplin; A Couvelard; W W de Herder; B Erikssson; A Falchetti; M Falconi; P Komminoth; M Körner; J M Lopes; A-M McNicol; O Nilsson; A Perren; A Scarpa; J-Y Scoazec; B Wiedenmann Journal: Virchows Arch Date: 2006-09-12 Impact factor: 4.064
Authors: S Chiloiro; F Lanza; A Bianchi; G Schinzari; M G Brizi; A Giampietro; V Rufini; F Inzani; A Giordano; G Rindi; A Pontecorvi; L De Marinis Journal: Endocrine Date: 2017-05-31 Impact factor: 3.633
Authors: Ugo Marchese; Martin Gaillard; Anna Pellat; Stylianos Tzedakis; Einas Abou Ali; Anthony Dohan; Maxime Barat; Philippe Soyer; David Fuks; Romain Coriat Journal: Cancers (Basel) Date: 2022-01-15 Impact factor: 6.639