PMID- 25345822
OWN - NLM
STAT- MEDLINE
DCOM- 20170221
LR  - 20170817
IS  - 1445-2197 (Electronic)
IS  - 1445-1433 (Linking)
VI  - 86
IP  - 9
DP  - 2016 Sep
TI  - Assessing the short- and long-term outcomes after resection of benign insulinoma.
PG  - 706-10
LID - 10.1111/ans.12891 [doi]
AB  - BACKGROUND: Insulinoma is a rare functional pancreatic neuroendocrine tumour 
      (NET) believed to have an excellent long-term outcome, but few studies have 
      solely focused on this issue after apparently curative resection. This study 
      aimed to assess post-operative and long-term outcomes after resection of benign 
      insulinomas. METHODS: From 1998 to 2013, 36 consecutive patients with insulinomas 
      underwent surgery. Three patients had multiple endocrine neoplasia type-1 
      (MEN-1). Demographics, operative findings, tumour grade (2010 World Health 
      Organization (WHO) NET classification), post-operative pancreatic fistula (POPF) 
      grade (International Study Group of Pancreatic Fistula (ISGPF)), complications 
      and recurrence were analysed. RESULTS: Eighteen (50%) had enucleation while the 
      rest underwent pancreatic resection. The majority (86.1%) of insulinomas belonged 
      to WHO NET grade G1. POPF occurred in 58.3% of patients while clinical fistula 
      (ISGPF grades B and C) occurred in 19.4%. One (2.8%) patient required 
      reoperation. The occurrence of POPF was not related to type of resection or 
      surgical approach. There was no perioperative mortality. After a mean follow-up 
      of 83.6 months, two patients (5.7%) developed disease recurrence at 34.4 and 
      131.9 months after initial surgery. No patients developed distant metastasis. The 
      10- and 15-year disease-free rates were 95.6 and 85.4%, respectively. CONCLUSION: 
      POPF occurred frequently and posed a significant morbidity after resection of 
      insulinoma. However, it occurred independently of type of resection or surgical 
      approach. Although the immediate cure rate after resection was high (100%), 
      long-term disease recurrence in sporadic (non-MEN-1) cases was not insignificant. 
      Regular long-term follow-up is recommended.
CI  - (c) 2014 Royal Australasian College of Surgeons.
FAU - Tsang, Yi-Po
AU  - Tsang YP
AD  - Division of Endocrine Surgery, Department of Surgery, The University of Hong 
      Kong, Hong Kong.
FAU - Lang, Brian Hung-Hin
AU  - Lang BH
AD  - Division of Endocrine Surgery, Department of Surgery, The University of Hong 
      Kong, Hong Kong.
FAU - Shek, Tony Wai-Hung
AU  - Shek TW
AD  - Department of Pathology, The University of Hong Kong, Hong Kong.
LA  - eng
PT  - Journal Article
DEP - 20141023
PL  - Australia
TA  - ANZ J Surg
JT  - ANZ journal of surgery
JID - 101086634
SB  - IM
MH  - Endosonography
MH  - Female
MH  - Follow-Up Studies
MH  - Hong Kong/epidemiology
MH  - Humans
MH  - Incidence
MH  - Insulinoma/diagnosis/*surgery
MH  - Laparoscopy/*methods
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Pancreatectomy/*methods
MH  - Pancreatic Neoplasms/diagnosis/*surgery
MH  - Postoperative Complications/*epidemiology
MH  - Retrospective Studies
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
OTO - NOTNLM
OT  - enucleation
OT  - insulinoma
OT  - pancreatectomy
OT  - pancreatic fistula
OT  - recurrence
EDAT- 2014/10/28 06:00
MHDA- 2017/02/22 06:00
CRDT- 2014/10/28 06:00
PHST- 2014/09/15 00:00 [accepted]
PHST- 2014/10/28 06:00 [entrez]
PHST- 2014/10/28 06:00 [pubmed]
PHST- 2017/02/22 06:00 [medline]
AID - 10.1111/ans.12891 [doi]
PST - ppublish
SO  - ANZ J Surg. 2016 Sep;86(9):706-10. doi: 10.1111/ans.12891. Epub 2014 Oct 23.