PMID- 26731608
OWN - NLM
STAT- MEDLINE
DCOM- 20170515
LR  - 20171221
IS  - 1423-0194 (Electronic)
IS  - 0028-3835 (Linking)
VI  - 103
IP  - 6
DP  - 2016
TI  - Active Surveillance versus Surgery of Nonfunctioning Pancreatic Neuroendocrine 
      Neoplasms </=2 cm in MEN1 Patients.
PG  - 779-86
LID - 10.1159/000443613 [doi]
AB  - BACKGROUND: The aim of this study was to evaluate the efficacy of conservative 
      treatment for nonfunctioning pancreatic neuroendocrine neoplasms (NF-PNEN) </=2 cm 
      in multiple endocrine neoplasia type 1 (MEN1)-affected patients compared with 
      surgical treatment. METHODS: The databases of 4 tertiary referral institutions 
      (San Raffaele Scientific Institute, Milan; Philipps-Universitat Marburg, Marburg; 
      University of Padua, Padua; Royal Free Hospital, London) were analyzed. A 
      comparison of conservative management and surgery at initial diagnosis of NF-PNEN 
      </=2 cm between 1997 and 2013 was performed. RESULTS: Overall, 27 patients (45%) 
      underwent up-front surgery and 33 patients (55%) were followed up after the 
      initial diagnosis. A higher proportion of patients in the surgery group were 
      female (70 vs. 33%, p = 0.004). Patients were mainly operated on in the period 
      1997-2007 as compared with the period 2008-2013 (n = 17; 63 vs. 37%; p = 0.040). 
      The rate of multifocal tumors was higher in the surgery group (n = 24; 89%) than 
      in the 'no surgery' group (n = 22; 67%; p = 0.043). After a median follow-up of 
      126 months, 1 patient deceased due to postoperative complications within 30 days 
      after surgery. The 5-, 10-, and 15-year progression-free survival (PFS) rates 
      were 63, 39, and 10%, respectively. The median PFS was similar in the two groups. 
      Overall, 13 patients (32.5%) were operated on after initial surgical or 
      conservative treatment. The majority of the surgically treated patients had stage 
      1 (77.5%), T1 (77.5%), and G1 (85%) tumors. CONCLUSIONS: NF-PNEN </=2 cm in MEN1 
      patients are indolent neoplasms posing a low oncological risk. Surgical treatment 
      of these tumors at initial diagnosis is rarely justified in favor of conservative 
      treatment.
CI  - (c) 2016 S. Karger AG, Basel.
FAU - Partelli, Stefano
AU  - Partelli S
AD  - Pancreatic Surgery Unit, Department of Internal Medicine, IRCCS San Raffaele 
      Hospital, Vita-Salute San Raffaele University, Milan, Italy.
FAU - Tamburrino, Domenico
AU  - Tamburrino D
FAU - Lopez, Caroline
AU  - Lopez C
FAU - Albers, Max
AU  - Albers M
FAU - Milanetto, Anna Caterina
AU  - Milanetto AC
FAU - Pasquali, Claudio
AU  - Pasquali C
FAU - Manzoni, Marco
AU  - Manzoni M
FAU - Toumpanakis, Christos
AU  - Toumpanakis C
FAU - Fusai, Giuseppe
AU  - Fusai G
FAU - Bartsch, Detlef
AU  - Bartsch D
FAU - Falconi, Massimo
AU  - Falconi M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160106
PL  - Switzerland
TA  - Neuroendocrinology
JT  - Neuroendocrinology
JID - 0035665
SB  - IM
MH  - Adult
MH  - Databases, Factual/statistics & numerical data
MH  - *Disease-Free Survival
MH  - Europe
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Multiple Endocrine Neoplasia Type 1/*surgery
MH  - Pancreatectomy/*methods
MH  - Pancreatic Neoplasms/*surgery
MH  - Retrospective Studies
MH  - *Treatment Outcome
EDAT- 2016/01/06 06:00
MHDA- 2017/05/16 06:00
CRDT- 2016/01/06 06:00
PHST- 2015/08/05 00:00 [received]
PHST- 2015/12/20 00:00 [accepted]
PHST- 2016/01/06 06:00 [entrez]
PHST- 2016/01/06 06:00 [pubmed]
PHST- 2017/05/16 06:00 [medline]
AID - 000443613 [pii]
AID - 10.1159/000443613 [doi]
PST - ppublish
SO  - Neuroendocrinology. 2016;103(6):779-86. doi: 10.1159/000443613. Epub 2016 Jan 6.