Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center
PurposeNeuroendocrine tumors of the pancreas (Pan-NETs) are usually hormonally inactive with a capacity to metastasize. Since Pan-NETs are rare, more knowledge is needed.MethodsWe reviewed all patients’ medical files with Pan-NET treated at a tertiary center (2006-2019). Grade 1 (G1) and grade 2 (G2...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.657698/full |
| _version_ | 1830355902699405312 |
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| author | Jan Calissendorff Jan Calissendorff Freja Bjellerup-Calissendorff Freja Bjellerup-Calissendorff Robert Bränström Robert Bränström C. Christofer Juhlin C. Christofer Juhlin Henrik Falhammar Henrik Falhammar |
| author_facet | Jan Calissendorff Jan Calissendorff Freja Bjellerup-Calissendorff Freja Bjellerup-Calissendorff Robert Bränström Robert Bränström C. Christofer Juhlin C. Christofer Juhlin Henrik Falhammar Henrik Falhammar |
| author_sort | Jan Calissendorff |
| collection | DOAJ |
| description | PurposeNeuroendocrine tumors of the pancreas (Pan-NETs) are usually hormonally inactive with a capacity to metastasize. Since Pan-NETs are rare, more knowledge is needed.MethodsWe reviewed all patients’ medical files with Pan-NET treated at a tertiary center (2006-2019). Grade 1 (G1) and grade 2 (G2) tumors were compared. The latter group was subdivided arbitrarily based on proliferation index into G2a (3-9.9%) and G2b (10-19.9%).ResultsWe found 137 patients (76 females, 61 males; G1 n=66, G2 n=42), the median age at diagnosis 61 years (interquartile range (IQR) 50–71), and tumor size 2 cm (1.3–5 cm). The initial surgery was performed in 101 patients. The remaining (n=36) were followed conservatively. Metastatic disease was evident in 22 patients (16%) at diagnosis while new lesions developed in 13 out of 22 patients (59%). In patients without previous metastatic disease, progressive disease was discovered in 29% of G1 vs. 55% of G2 patients (P=0.009), 47% of G2a vs. 75% of G2b patients (NS). Survival was poorer in patients with metastasis at diagnosis vs. those with local disease (P<0.001). During follow-up of 74 months, Pan-NET related death was found in 10 patients. Survival was not different between G1 vs. G2 or G2a vs. G2b, or if tumors were functional. Size ≤2 cm was associated with a better outcome (P=0.004). During the follow-up of small tumors (≤2 cm, n=36) two were resected.ConclusionIn small non-functional Pan-NETs, active surveillance is reasonable. Progressive disease was more common in G2, but survival was similar in G1, G2 and between G2 subgroups. Survival was poorer in patients with metastasis at diagnosis. |
| first_indexed | 2024-12-20T01:56:14Z |
| format | Article |
| id | doaj.art-b4f9d82ed1b64792b1b441a8623fb1f8 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-20T01:56:14Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-b4f9d82ed1b64792b1b441a8623fb1f82022-12-21T19:57:29ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-04-011210.3389/fendo.2021.657698657698Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral CenterJan Calissendorff0Jan Calissendorff1Freja Bjellerup-Calissendorff2Freja Bjellerup-Calissendorff3Robert Bränström4Robert Bränström5C. Christofer Juhlin6C. Christofer Juhlin7Henrik Falhammar8Henrik Falhammar9Department of Endocrinology, Karolinska University Hospital, Stockholm, SwedenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Pathology, Västmanland County Hospital, Västerås, SwedenCenter for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, SwedenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Breast, Endocrine and Sarcoma Surgery, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, SwedenDepartment of Endocrinology, Karolinska University Hospital, Stockholm, SwedenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenPurposeNeuroendocrine tumors of the pancreas (Pan-NETs) are usually hormonally inactive with a capacity to metastasize. Since Pan-NETs are rare, more knowledge is needed.MethodsWe reviewed all patients’ medical files with Pan-NET treated at a tertiary center (2006-2019). Grade 1 (G1) and grade 2 (G2) tumors were compared. The latter group was subdivided arbitrarily based on proliferation index into G2a (3-9.9%) and G2b (10-19.9%).ResultsWe found 137 patients (76 females, 61 males; G1 n=66, G2 n=42), the median age at diagnosis 61 years (interquartile range (IQR) 50–71), and tumor size 2 cm (1.3–5 cm). The initial surgery was performed in 101 patients. The remaining (n=36) were followed conservatively. Metastatic disease was evident in 22 patients (16%) at diagnosis while new lesions developed in 13 out of 22 patients (59%). In patients without previous metastatic disease, progressive disease was discovered in 29% of G1 vs. 55% of G2 patients (P=0.009), 47% of G2a vs. 75% of G2b patients (NS). Survival was poorer in patients with metastasis at diagnosis vs. those with local disease (P<0.001). During follow-up of 74 months, Pan-NET related death was found in 10 patients. Survival was not different between G1 vs. G2 or G2a vs. G2b, or if tumors were functional. Size ≤2 cm was associated with a better outcome (P=0.004). During the follow-up of small tumors (≤2 cm, n=36) two were resected.ConclusionIn small non-functional Pan-NETs, active surveillance is reasonable. Progressive disease was more common in G2, but survival was similar in G1, G2 and between G2 subgroups. Survival was poorer in patients with metastasis at diagnosis.https://www.frontiersin.org/articles/10.3389/fendo.2021.657698/fullneuroendocrine neoplasiapancreatictreatmentoutcomesurvivalKi-67 |
| spellingShingle | Jan Calissendorff Jan Calissendorff Freja Bjellerup-Calissendorff Freja Bjellerup-Calissendorff Robert Bränström Robert Bränström C. Christofer Juhlin C. Christofer Juhlin Henrik Falhammar Henrik Falhammar Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center Frontiers in Endocrinology neuroendocrine neoplasia pancreatic treatment outcome survival Ki-67 |
| title | Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center |
| title_full | Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center |
| title_fullStr | Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center |
| title_full_unstemmed | Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center |
| title_short | Characteristics, Treatment, Outcomes, and Survival in Neuroendocrine G1 and G2 Pancreatic Tumors: Experiences From a Single Tertiary Referral Center |
| title_sort | characteristics treatment outcomes and survival in neuroendocrine g1 and g2 pancreatic tumors experiences from a single tertiary referral center |
| topic | neuroendocrine neoplasia pancreatic treatment outcome survival Ki-67 |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.657698/full |
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