Resection of pancreatic neuroendocrine tumors: defining patterns and time course of recurrence. HPB : the official journal of the International Hepato Pancreato Biliary Association Dong, D., Zhang, X., Lopez-Aguiar, A. G., Poultsides, G., Makris, E., Rocha, F., Kanji, Z., Weber, S., Fisher, A., Fields, R., Krasnick, B. A., Idrees, K., Smith, P. M., Cho, C., Beems, M., Dillhoff, M., Maithel, S. K., Pawlik, T. M. 2019


BACKGROUND: To define recurrence patterns and time course, as well as risk factors associated with recurrence following curative resection of pNETs.METHOD: Patients who underwent curative-intent resection for pNET between 1997 and 2016 were identified from the US Neuroendocrine Tumor Study Group. Data on baseline and tumor-specific characteristics, overall survival (OS), timing and first-site of recurrence, predictors and recurrence management were analyzed.RESULTS: Among 1020 patients, 154 (15.1%) patients developed recurrence. Among patients who experienced recurrence, 76 (49.4%) had liver-only recurrence, while 35 (22.7%) had pancreas-only recurrence. The proportion of liver-only recurrence increased from 54.3% within one-year after surgery to 61.5% from four-to-six years after surgery; whereas the proportion of pancreas-only recurrence decreased from 26.1% to 7.7% over these time periods. While liver-only recurrence was associated with tumor characteristics, pancreas-only recurrence was only associated with surgical margin status. Patients undergoing curative resection of recurrence had comparable OS with patients who had no recurrence (median OS, pancreas-only recurrence, 133.9 months; liver-only recurrence, not attained; no recurrence, 143.0 months, p=0.499) CONCLUSIONS: Different recurrence patterns and timing course, as well as risk factors suggest biological heterogeneity of pNET recurrence. A personalized approach to postoperative surveillance and treatment of recurrence disease should be considered.

View details for DOI 10.1016/j.hpb.2019.05.020

View details for PubMedID 31235429