Sjoerd Nell1, Inne H M Borel Rinkes2, Helena M Verkooijen3, Bert A Bonsing4, Casper H van Eijck5, Harry van Goor6, Ruben H J de Kleine7, Geert Kazemier8, Elisabeth J Nieveen van Dijkum9, Cornelis H C Dejong10, Gerlof D Valk11, Menno R Vriens12. 1. Department of Endocrine Surgical Oncology and Endocrine Oncology, University Medical Center Utrecht, Utrecht, the Netherlands. 2. Department of Surgical Oncology and Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands. 4. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands. 5. Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands. 6. Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. 7. Department of Hepato-Pancreatico-Biliary and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 8. Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands. 9. Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands. 10. Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. 11. Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, the Netherlands. 12. Department of Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
Abstract
OBJECTIVE: To estimate short and long-term morbidity after pancreatic surgery for multiple endocrine neoplasia type 1 (MEN1)-related nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs). BACKGROUND: Fifty percent of the MEN1 patients harbor multiple NF-pNETs. The decision to proceed to NF-pNET surgery is a balance between the risk of disease progression versus the risk of surgery-related morbidity. Currently, there are insufficient data on the surgical complications after MEN1 NF-pNET surgery. METHODS: MEN1 patients diagnosed with a NF-pNET who underwent surgery were selected from the DutchMEN1 study group database, including >90% of the Dutch MEN1 population. Early postoperative complications, new-onset diabetes mellitus, and exocrine pancreatic insufficiency were captured. RESULTS: Sixty-one patients underwent NF-pNET surgery at 1 of the 8 Dutch academic centers. Patients were young (median age 41 years) with low American Society of Anesthesiologists scores. Median NF-pNET size on imaging was 22 mm (3-157). Thirty-three percent (19/58) of the patients developed major early-Clavien-Dindo grade III to IV-complications mainly consisting International Study Group of Pancreatic Surgery grade B/C pancreatic fistulas. Twenty-three percent of the patients (14/61) developed endocrine or exocrine pancreas insufficiency. The development of major early postoperative complications was independent of the NF-pNET tumor size. Twenty-one percent of the patients (12/58) developed multiple major early complications. CONCLUSIONS: MEN1 NF-pNET surgery is associated with high rates of major short and long-term complications. Current findings should be taken into account in the shared decision-making process when MEN1 NF-pNET surgery is considered.
OBJECTIVE: To estimate short and long-term morbidity after pancreatic surgery for multiple endocrine neoplasia type 1 (MEN1)-related nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs). BACKGROUND: Fifty percent of the MEN1patients harbor multiple NF-pNETs. The decision to proceed to NF-pNET surgery is a balance between the risk of disease progression versus the risk of surgery-related morbidity. Currently, there are insufficient data on the surgical complications after MEN1 NF-pNET surgery. METHODS:MEN1patients diagnosed with a NF-pNET who underwent surgery were selected from the DutchMEN1 study group database, including >90% of the Dutch MEN1 population. Early postoperative complications, new-onset diabetes mellitus, and exocrine pancreatic insufficiency were captured. RESULTS: Sixty-one patients underwent NF-pNET surgery at 1 of the 8 Dutch academic centers. Patients were young (median age 41 years) with low American Society of Anesthesiologists scores. Median NF-pNET size on imaging was 22 mm (3-157). Thirty-three percent (19/58) of the patients developed major early-Clavien-Dindo grade III to IV-complications mainly consisting International Study Group of Pancreatic Surgery grade B/C pancreatic fistulas. Twenty-three percent of the patients (14/61) developed endocrine or exocrine pancreas insufficiency. The development of major early postoperative complications was independent of the NF-pNET tumor size. Twenty-one percent of the patients (12/58) developed multiple major early complications. CONCLUSIONS:MEN1 NF-pNET surgery is associated with high rates of major short and long-term complications. Current findings should be taken into account in the shared decision-making process when MEN1 NF-pNET surgery is considered.
Authors: Dirk-Jan van Beek; Helena M Verkooijen; Sjoerd Nell; Bert A Bonsing; Casper H van Eijck; Harry van Goor; Frederik J H Hoogwater; Elisabeth J M Nieveen van Dijkum; Geert Kazemier; Cornelis H C Dejong; Lodewijk A A Brosens; Frank J Wessels; Inne H M Borel Rinkes; Gerlof D Valk; Menno R Vriens Journal: Neuroendocrinology Date: 2020-07-28 Impact factor: 4.914
Authors: Dirk-Jan van Beek; Sjoerd Nell; Wessel M C M Vorselaars; Bert A Bonsing; Casper H J van Eijck; Harry van Goor; Elisabeth J Nieveen van Dijkum; Cornelis H C Dejong; Gerlof D Valk; Inne H M Borel Rinkes; Menno R Vriens Journal: Ann Surg Oncol Date: 2021-01-31 Impact factor: 5.344
Authors: Dirk-Jan van Beek; Sjoerd Nell; Helena M Verkooijen; Inne H M Borel Rinkes; Gerlof D Valk; Menno R Vriens Journal: Surgery Date: 2020-11-19 Impact factor: 4.348
Authors: Maria Luisa Brandi; Sunita K Agarwal; Nancy D Perrier; Kate E Lines; Gerlof D Valk; Rajesh V Thakker Journal: Endocr Rev Date: 2021-03-15 Impact factor: 19.871