Presented at the 9th Annual Meeting of the American Hepato-Pancreato-Biliary Association, 12–15 March 2009, Miami, FL, USA.
A simplified prognostic system for resected pancreatic neuroendocrine neoplasms
Article first published online: 22 JUL 2009
© 2009 International Hepato-Pancreato-Biliary Association
Volume 11, Issue 5, pages 422–428, August 2009
How to Cite
Ballian, N., Loeffler, A. G., Rajamanickam, V., Norstedt, P. A., Weber, S. M. and Cho, C. S. (2009), A simplified prognostic system for resected pancreatic neuroendocrine neoplasms. HPB, 11: 422–428. doi: 10.1111/j.1477-2574.2009.00082.x
- Issue published online: 22 JUL 2009
- Article first published online: 22 JUL 2009
- Received 19 March 2009; accepted 20 April 2009
Background: A number of prognostically relevant clinicopathological variables have been proposed for pancreatic neuroendocrine neoplasms. However, a standardized prognostication system has yet to be established for patients undergoing potentially curative tumour resection.
Methods: We examined a prospectively maintained, single-institution database to identify patients who underwent potentially curative resection of non-metastatic primary pancreatic neuroendocrine neoplasms. Patient, operative and pathological characteristics were analysed to identify variables associated with disease-specific and disease-free survival.
Results: Between 1991 and 2007, 43 patients met inclusion criteria. After a median follow-up of 68 months, 5-year disease-specific survival was 94% and 5-year disease-free survival was 72%. Tumours sized ≥5 cm and vascular invasion were associated with worse disease-specific survival. Tumours sized ≥5 cm, nodal metastases, positive resection margins and perineural invasion were associated with worse disease-free survival. A scoring system consisting of tumour size ≥5 cm, histological grade, nodal metastases and resection margin positivity (SGNM) permitted stratification of disease-specific (P= 0.006) and disease-free (P= 0.0004) survival. This proposed scoring system demonstrated excellent discrimination of individual disease-specific and disease-free survival outcomes as reflected by concordance indices of 0.814 and 0.794, respectively.
Conclusions: A simple scoring system utilizing tumour size, histological grade, nodal metastases and resection margin status can be used to stratify outcomes in patients undergoing resection of primary pancreatic neuroendocrine neoplasms.