Factores pronósticos de los tumores neuroendocrinos de páncreas resecados. Experiencia en 95 pacientes / Prognostic factors in resected pancreatic neuroendocrine tumours: Experience in 95 patients

INTRODUCCIÓN: El objetivo de este estudio fue analizar los factores pronósticos que influyen en la supervivencia y en la recidiva en una serie de pacientes diagnosticados de tumores neuroendocrinos de páncreas (TNEP) y tratados mediante resección quirúrgica. MÉTODOS: Serie retrospectiva de 95 pacientes intervenidos y resecados de TNEP. Las variables estudiadas son: edad, sexo, forma de presentación (esporádica/familiar), funcionalidad, tipo de tumor, localización, cirugía realizada, tamaño tumoral, multifocalidad, tasa de curación y de recidiva. Se ha utilizado la nueva clasificación de la OMS en 2010. RESULTADOS: De los 95 pacientes, 45 eran varones y 50 mujeres, con una edad media de 47,6 años. Presentación esporádica en 66 pacientes (69,8%) y familiar en los 29 restantes (30,2%), asociados a síndrome MEN 1. El 59% (56 pacientes) eran no funcionantes y el 41% restante funcionantes. Los TNEP funcionantes incluían 20 insulinomas, 16 gastrinomas y 3 glucagonomas. La técnica quirúrgica más utilizada (42 pacientes) fue la pancreatectomía corporocaudal. Según la clasificación de la OMS (2010), 59 pacientes presentaban un TNEP G1, 24 un TNEP G2 y los 12 pacientes restantes un carcinoma pobremente diferenciado. La supervivencia a los 5 años en los tumores bien diferenciados ha sido del 100%, independientemente de la funcionalidad. Los TNE esporádicos suelen ser unifocales (p < 0,001) y se asocian a metástasis hepáticas. El seguimiento medio ha sido de 85,3 meses, con una tasa de supervivencia del 65,8% y de recidiva del 24%. CONCLUSIONES: En nuestra experiencia, la clasificación de la OMS (2010) es un factor pronóstico independiente en la supervivencia de los TNEP

INTRODUCTION: The aim of this study was to analyze prognostic factors for survival and recurrence in patients with resected pancreatic neuroendocrine tumors (PNT). METHODS: Medical records of 95 patients with resected PNT were retrospectively reviewed. The variables studied were: age, sex, form of presentation (sporadic/familial tumors), functionality, type of tumor, localization, type of surgery, tumor size, multifocal tumors and recurrent rate. The new WHO classification (2010) was used. RESULTS: There were 45 men and 50 women. Mean age was 46.8 years. Regarding the mode of presentation, it was sporadic in 66 patients (69.8%) and 29 cases were familial neuroendocrine tumors (30.2%) in association with MEN 1 syndrome. The 59% of patients suffered from non-functional tumors and 41% were functional: 20 insulinoma, 16 gastrinoma, and 3 glucagonoma. Distal pancreatectomy was the most common surgical procedure, followed by tumor enucleation in 19 patients. According to the WHO classification, 59 patients had a PNT G1, 24 PNT G2 and 12 with a poorly-differentiated carcinoma, respectively. The 5-year survival in well-differentiated tumors was 100%, regardless of the functionality. Sporadic PNT are more commonly unifocal (P<0.001), associating liver metastasis. Survival and recurrence rates after a mean follow-up of 85.3 months were 65.8 and 24%, respectively. CONCLUSIONS: In our experience, WHO classification was an independent prognostic factor in PNT survival

Prognostic factors in resected pancreatic neuroendocrine tumours: Experience in 95 patients. / Factores pronósticos de los tumores neuroendocrinos de páncreas resecados. Experiencia en 95 pacientes.

INTRODUCTION: The aim of this study was to analyze prognostic factors for survival and recurrence in patients with resected pancreatic neuroendocrine tumors (PNT). METHODS: Medical records of 95 patients with resected PNT were retrospectively reviewed. The variables studied were: age, sex, form of presentation (sporadic/familial tumors), functionality, type of tumor, localization, type of surgery, tumor size, multifocal tumors and recurrent rate. The new WHO classification (2010) was used. RESULTS: There were 45 men and 50 women. Mean age was 46.8 years. Regarding the mode of presentation, it was sporadic in 66 patients (69.8%) and 29 cases were familial neuroendocrine tumors (30.2%) in association with MEN 1 syndrome. The 59% of patients suffered from non-functional tumors and 41% were functional: 20 insulinoma, 16 gastrinoma, and 3 glucagonoma. Distal pancreatectomy was the most common surgical procedure, followed by tumor enucleation in 19 patients. According to the WHO classification, 59 patients had a PNT G1, 24 PNT G2 and 12 with a poorly-differentiated carcinoma, respectively. The 5-year survival in well-differentiated tumors was 100%, regardless of the functionality. Sporadic PNT are more commonly unifocal (P<0.001), associating liver metastasis. Survival and recurrence rates after a mean follow-up of 85.3 months were 65.8 and 24%, respectively. CONCLUSIONS: In our experience, WHO classification was an independent prognostic factor in PNT survival.