Well-differentiated grade 1 and 2 nonfunctioning pancreatic neuroendocrine tumor: Consideration of additional factors to aid treatment decision-making - 07/11/25
Abstract |
Background |
Guidelines for 1–2 cm well-differentiated non-functional pancreatic neuroendocrine tumors (NF-PNET) are broad; observation (OB), enucleation (EN), and pancreatic resection (PR) all viable. The objective is analyzing factors impacting survival between approaches.
Methods |
Retrospective analysis of NCDB for 1–2 cm well-differentiated grade 1/2 NF-PNET stratified by approach. Factors predicting survival analyzed using Cox regression.
Results |
4023 patients included; 1030 OB, 321 EN, and 2672 PR. EN was associated with improved survival (HR 0.20, 95 %CI 0.08–0.53) and was dependent on negative margins (margin negative: HR 0.12, 95 %CI 0.05–0.34). Positive margins for EN were high (29.7 % EN vs. 3.4 % PR, p < 0.01). Factors influencing margins for EN were pancreatic tail location (OR 0.36, 95 %CI 0.13–0.98) and lymphovascular invasion (OR 5.28, 95 %CI 1.42–19.53). Among PRs, only distal pancreatectomy conferred improved survival (HR 0.53, 95 %CI 0.30–0.92).
Conclusion |
Optimal treatment for 1–2 cm well-differentiated NF-PNET should incorporate factors influencing positive margins for EN and resection type for PR.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Survival benefit of enucleation and resection over observation are dependent on margins in 1-2 cm well-diff pancreatic NETs. |
• | However, positive margin rate for enucleation is high (29.7 %) compared to pancreatic resection (3.4 %). |
• | Pancreatic tail location and lack of lymphovascular invasion are associated with higher negative margin rate for enucleation. |
• | Among pancreatic resection, only distal pancreatectomy conferred improved survival over observation. |
Keywords : Non-functional pancreatic neuroendocrine tumor, Observation, Enucleation, Pancreatic resection, NCCN guidelines
Plan
Vol 250
Article 116622- décembre 2025 Retour au numéro
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