Tumour diameter is not reliable for management of non-secreting pancreatic neuroendocrine tumours
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Tumour diameter is not reliable for management of non-secreting pancreatic neuroendocrine tumours. / Mills, Logan; Drymousis, Panagiotis; Vashist, Yogesh; Burdelski, Christoph; Prachalias, Andreas; Srinivasan, Parthi; Menon, Krishna; Cotoi, Corina; Khan, Saboor; Cave, Judith; Armstrong, Thomas; Weickert, Martin O; Izbicki, Jakob; Schrader, Joerg; Frilling, Andreja; Ramage, John K; Srirajaskanthan, Raj.
In: ENDOCR CONNECT, Vol. 6, No. 8, 11.2017, p. 876-885.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Tumour diameter is not reliable for management of non-secreting pancreatic neuroendocrine tumours
AU - Mills, Logan
AU - Drymousis, Panagiotis
AU - Vashist, Yogesh
AU - Burdelski, Christoph
AU - Prachalias, Andreas
AU - Srinivasan, Parthi
AU - Menon, Krishna
AU - Cotoi, Corina
AU - Khan, Saboor
AU - Cave, Judith
AU - Armstrong, Thomas
AU - Weickert, Martin O
AU - Izbicki, Jakob
AU - Schrader, Joerg
AU - Frilling, Andreja
AU - Ramage, John K
AU - Srirajaskanthan, Raj
N1 - © 2017 The authors.
PY - 2017/11
Y1 - 2017/11
N2 - Small non-functioning pancreatic NETs (pNETs) ≤2 cm can pose a management dilemma in terms of surveillance or resection. There is evidence to suggest that a surveillance approach can be considered since there are no significant radiological changes observed in lesions during long-term follow-up. However, other studies have suggested loco-regional spread can be present in ≤2 cm pNETs. The aim of this study was to characterise the prevalence of malignant features and identify any useful predictive variables in a surgically resected cohort of pNETs. 418 patients with pNETs were identified from 5 NET centres. Of these 227 were included for main analysis of tumour characteristics. Mean age of patients was 57 years, 47% were female. The median follow-up was 48.2 months. Malignant features were identified in 38% of ≤2 cm pNETs. ROC analysis showed that the current cut-off of 20 mm had a sensitivity of 84% for malignancy. The rate of malignant features is in keeping with other surgical series and challenges the belief that small pNETs have a low malignant potential. This study does not support a 20 mm size cut-off as being a solitary safe parameter to exclude malignancy in pNETs.
AB - Small non-functioning pancreatic NETs (pNETs) ≤2 cm can pose a management dilemma in terms of surveillance or resection. There is evidence to suggest that a surveillance approach can be considered since there are no significant radiological changes observed in lesions during long-term follow-up. However, other studies have suggested loco-regional spread can be present in ≤2 cm pNETs. The aim of this study was to characterise the prevalence of malignant features and identify any useful predictive variables in a surgically resected cohort of pNETs. 418 patients with pNETs were identified from 5 NET centres. Of these 227 were included for main analysis of tumour characteristics. Mean age of patients was 57 years, 47% were female. The median follow-up was 48.2 months. Malignant features were identified in 38% of ≤2 cm pNETs. ROC analysis showed that the current cut-off of 20 mm had a sensitivity of 84% for malignancy. The rate of malignant features is in keeping with other surgical series and challenges the belief that small pNETs have a low malignant potential. This study does not support a 20 mm size cut-off as being a solitary safe parameter to exclude malignancy in pNETs.
KW - Journal Article
U2 - 10.1530/EC-17-0293
DO - 10.1530/EC-17-0293
M3 - SCORING: Journal article
C2 - 29150545
VL - 6
SP - 876
EP - 885
JO - ENDOCR CONNECT
JF - ENDOCR CONNECT
SN - 2049-3614
IS - 8
ER -
