Abstract
Background
Because of their rarity and indolent nature, optimal management of malignant pancreatic neuroendocrine tumors remains controversial. The purpose of this study is to review a series of patients with these tumors and investigate the role of surgery in the treatment.
Methods
A retrospective study of 73 patients (ages 24โ86 years; 36 women) undergoing treatment at a tertiary academic medical center was performed. Patient demographics, diagnostic tests, operations, pathologic findings, adjuvant treatments, and survival were reviewed.
Results
Seventyโfour percent of patients had advanced disease with hepatic metastases and 30% had functional tumors. Fiftyโseven percent of the patients underwent pancreatic resections. Two 60โday mortalities occurred and the postoperative complication rate was 27%. Overall 5โyear survival rate was 44%. There was no difference in survival between patients with functional and nonfunctional tumors. Patients undergoing resection, even in metastatic disease, had better survival than patients who had no resection (60% vs. 30%, Pโ=โ0.025). Recurrence occurred in 20% of patients who underwent a curative resection.
Conclusion
Patients with malignant pancreatic neuroendocrine tumors commonly present with advanced disease. Although, curative resection is not frequent, survival benefit may be obtainable with aggressive surgical management even in the face of metastatic disease. J. Surg. Oncol. 2007;96:397โ403. ยฉ 2007 WileyโLiss, Inc.