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Indications and outcomes of enucleation versus formal pancreatectomy for pancreatic neuroendocrine tumors.
Heidsma, Charlotte M; Tsilimigras, Diamantis I; van Dieren, Susan; Rocha, Flavio; Abbott, Daniel E; Fields, Ryan; Smith, Paula M; Poultsides, George A; Cho, Cliff; Dillhoff, Mary; Lopez-Aguiar, Alexandra G; Kanji, Zaheer; Fisher, Alexander; Krasnick, Bradley A; Idrees, Kamran; Makris, Eleftherios; Beems, Megan; van Eijck, Casper H J; Nieveen van Dijkum, Elisabeth J M; Maithel, Shishir K; Pawlik, Timothy M.
Afiliação
  • Heidsma CM; Department of Surgery, The Ohio State University, Wexner Medical Center, 410 W 10th Ave, OH 43210, Columbus, USA; Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
  • Tsilimigras DI; Department of Surgery, The Ohio State University, Wexner Medical Center, 410 W 10th Ave, OH 43210, Columbus, USA.
  • van Dieren S; Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
  • Rocha F; Department of Surgery, Virginia Mason Medical Center, 1100 9th Ave, Seattle, WA, 98101, USA.
  • Abbott DE; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, 750 Highland Ave, WI, 53726, USA.
  • Fields R; Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO, 63110, USA.
  • Smith PM; Division of Surgical Oncology, Department of Surgery, Vanderbilt University, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
  • Poultsides GA; Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305-2200, USA.
  • Cho C; Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
  • Dillhoff M; Department of Surgery, The Ohio State University, Wexner Medical Center, 410 W 10th Ave, OH 43210, Columbus, USA.
  • Lopez-Aguiar AG; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA.
  • Kanji Z; Department of Surgery, Virginia Mason Medical Center, 1100 9th Ave, Seattle, WA, 98101, USA.
  • Fisher A; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, 750 Highland Ave, WI, 53726, USA.
  • Krasnick BA; Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO, 63110, USA.
  • Idrees K; Division of Surgical Oncology, Department of Surgery, Vanderbilt University, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
  • Makris E; Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305-2200, USA.
  • Beems M; Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
  • van Eijck CHJ; Department of Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands.
  • Nieveen van Dijkum EJM; Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
  • Maithel SK; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA.
  • Pawlik TM; Department of Surgery, The Ohio State University, Wexner Medical Center, 410 W 10th Ave, OH 43210, Columbus, USA. Electronic address: tim.pawlik@osumc.edu.
HPB (Oxford) ; 23(3): 413-421, 2021 03.
Article em En | MEDLINE | ID: mdl-32771338
ABSTRACT

BACKGROUND:

Pancreatoduodenectomy (PD) or distal pancreatectomy (DP) are common procedures for patients with a pancreatic neuroendocrine tumor (pNET). Nevertheless, certain patients may benefit from a pancreas-preserving resection such as enucleation (EN). The aim of this study was to define the indications and differences in long-term outcomes among patients undergoing EN and PD/DP.

METHODS:

Patients undergoing resection of a pNET between 1992 and 2016 were identified. Indications and outcomes were evaluated, and propensity score matching (PSM) analysis was performed to compare long-term outcomes between patients who underwent EN versus PD/DP.

RESULTS:

Among 1034 patients, 143 (13.8%) underwent EN, 304 (29.4%) PD, and 587 (56.8%) DP. Indications for EN were small size (1.5 cm, IQR1.0-1.9), functional tumors (58.0%) that were mainly insulinomas (51.7%). After PSM (n = 109 per group), incidence of postoperative pancreatic fistula (POPF) grade B/C was higher after EN (24.5%) compared with PD/DP (14.0%) (p = 0.049). Median recurrence-free survival (RFS) was comparable among patients who underwent EN (47 months, 95% CI23-71) versus PD/DP (37 months, 95% CI 33-47, p = 0.480).

CONCLUSION:

Comparable long-term outcomes were noted among patients who underwent EN versus PD/DP for pNET. The incidence of clinically significant POPF was higher after EN.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article