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Reappraisal of a 2-...
Reappraisal of a 2-Cm Cut-off Size for the Management of Cystic Pancreatic Neuroendocrine Neoplasms : A Multicenter International Study
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Maggino, Laura (författare)
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Schmidt, Andrea (författare)
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Käding, André (författare)
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- Westermark, Sofia (författare)
- Umeå universitet,Kirurgi
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Ceppa, Eugene P. (författare)
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Falconi, Massimo (författare)
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Javed, Ammar A. (författare)
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Landoni, Luca (författare)
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Pergolini, Ilaria (författare)
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Perinel, Julie (författare)
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Vollmer, Charles M. (författare)
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- Sund, Malin (författare)
- Umeå universitet,Kirurgi
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Gaujoux, Sebastien (författare)
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(creator_code:org_t)
- Wolters Kluwer, 2021
- 2021
- Engelska.
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Ingår i: Annals of Surgery. - : Wolters Kluwer. - 0003-4932 .- 1528-1140. ; 273:5, s. 973-981
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- OBJECTIVE: The aim of this study was to characterize an international cohort of resected cystic pancreatic neuroendocrine neoplasms (cPanNENs) and identify preoperative predictors of aggressive behavior.BACKGROUND: The characteristics of cPanNENs are unknown and their clinical management remains unclear. An observational strategy for asymptomatic cPanNENs ≤2 cm has been proposed by recent guidelines, but evidence is scarce and limited to single-institutional series.METHODS: Resected cPanNENs (1995-2017) from 16 institutions worldwide were included. Solid lesions (>50% solid component), functional tumors, and MEN-1 patients were excluded. Aggressiveness was defined as lymph node (LN) involvement, G3 grading, distant metastases, and/or recurrence.RESULTS: Overall, 263 resected cPanNENs were included, among which 177 (63.5%) were >2 cm preoperatively. A preoperative diagnosis of cPanNEN was established in 162 cases (61.6%) and was more frequent when patients underwent endoscopic ultrasound [EUS, odds ratio (OR) 2.69, 95% confidence interval (CI) 1.52-4.77] and somatostatin-receptor imaging (OR 3.681, 95% CI 1.809-7.490), and for those managed in specialized institutions (OR 3.12, 95% CI 1.57-6.21). Forty-one cPanNENs (15.6%) were considered aggressive. In the whole cohort, LN involvement on imaging, age >65 years, preoperative size >2 cm, and pancreatic duct dilation were independently associated with aggressive behavior. In asymptomatic patients, older age and a preoperative size >2 cm remained independently associated with aggressiveness. Only 1 of 61 asymptomatic cPanNENs ≤2 cm displayed an aggressive behavior.CONCLUSIONS: The diagnostic accuracy of cPanNENs is increased by the use of EUS and somatostatin-receptor imaging and is higher in specialized institutions. Preoperative size >2 cm is independently associated with aggressive behavior. Consequently, a watch-and-wait policy for sporadic asymptomatic cPanNENs ≤2 cm seems justified and safe for most patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- pancreatic neuroendocrine neoplasms
- pancreatic neuroendocrine tumors
- cystic pancreatic neoplasm
- cystic pancreatic tumors
- surgery
- surveillance
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- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Maggino, Laura
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Schmidt, Andrea
-
Käding, André
-
Westermark, Sofi ...
-
Ceppa, Eugene P.
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Falconi, Massimo
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visa fler...
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Javed, Ammar A.
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Landoni, Luca
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Pergolini, Ilari ...
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Perinel, Julie
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Vollmer, Charles ...
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Sund, Malin
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Gaujoux, Sebasti ...
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visa färre...
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