PMID- 30894303
OWN - NLM
STAT- MEDLINE
DCOM- 20191203
LR  - 20191203
IS  - 1424-3911 (Electronic)
IS  - 1424-3903 (Linking)
VI  - 19
IP  - 3
DP  - 2019 Apr
TI  - Patient characteristics and clinical outcomes following initial surgical 
      intervention for MEN1 associated pancreatic neuroendocrine tumours: A systematic 
      review and exploratory meta-analysis of the literature.
PG  - 462-471
LID - S1424-3903(19)30064-X [pii]
LID - 10.1016/j.pan.2019.03.002 [doi]
AB  - BACKGROUND: This systematic review aimed to define the outcomes of different 
      pancreatic resection procedures for multiple endocrine neoplasia type 1 (MEN1) 
      associated pancreatic neuroendocrine neoplasms (pNENs). METHODS: A search of 
      PubMed, MEDLINE and SCOPUS databases were performed in accordance with PRISMA 
      guidelines. RESULTS: Twenty-seven studies including 533 patients undergoing 
      initial pancreatic resection for MEN1 associated pNENs were included in this 
      systematic review. Three hundred and sixty-six (68.7%) distal pancreatectomies 
      (DP), 120 (22.5%) sole enucleations (SE) and 47 (8.8%) pancreaticoduodenectomies 
      (PD) were identified. SE was associated with a higher rate of recurrence than DP 
      (25/67, 37% vs 40/190, 21% respectively, P = 0.008) but a lower rate of endocrine 
      insufficiency than PD (1/20, 5% vs 8/21, 38% respectively, P = 0.010). A 
      meta-analysis of major pancreatic resections (PD or DP) vs SE in 15 studies 
      showed that SE is associated with an increased rate of recurrence (Major 
      resection 42/184, 23% vs SE 20/53, 38% RR 0.65 CI 0.43-0.96 P = 0.032) but 
      reduced rate of postoperative endocrine insufficiency (Resection 37/93, 40% vs SE 
      0/24, 0% RR 7.37 CI 1.57-34.64 P = 0.008). Similarly, insulinomas and functional 
      pNENs overall had lower rates of recurrence and reoperation with major resection. 
      There was no difference in the reoperation rates or survival outcomes after SE 
      compared with major pancreatic resections at follow-up (pooled overall mean 
      duration: 85 months). CONCLUSION: Major pancreatic resections for MEN1 associated 
      pNENs have a lower risk of recurrence and a higher risk of postoperative 
      endocrine insufficiency when compared to sole enucleation, but a similar rate of 
      reoperation and survival.
CI  - Copyright (c) 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.
FAU - Ratnayake, Chathura Bathiya Bandara
AU  - Ratnayake CBB
AD  - Department of Surgery, School of Medicine, Faculty of Medical and Health 
      Sciences, University of Auckland, Auckland, New Zealand.
FAU - Loveday, Benjamin Pt
AU  - Loveday BP
AD  - Department of Surgery, School of Medicine, Faculty of Medical and Health 
      Sciences, University of Auckland, Auckland, New Zealand; HPB Unit, Department of 
      General Surgery, Auckland City Hospital, Auckland, New Zealand.
FAU - Windsor, John Albert
AU  - Windsor JA
AD  - Department of Surgery, School of Medicine, Faculty of Medical and Health 
      Sciences, University of Auckland, Auckland, New Zealand; HPB Unit, Department of 
      General Surgery, Auckland City Hospital, Auckland, New Zealand.
FAU - Lawrence, Benjamin
AU  - Lawrence B
AD  - Regional Cancer and Blood Service, Auckland City Hospital, Auckland, New Zealand; 
      Discipline of Oncology, Faculty of Medical and Health Sciences, University of 
      Auckland, Auckland, New Zealand.
FAU - Pandanaboyana, Sanjay
AU  - Pandanaboyana S
AD  - Department of Surgery, School of Medicine, Faculty of Medical and Health 
      Sciences, University of Auckland, Auckland, New Zealand; HPB Unit, Department of 
      General Surgery, Auckland City Hospital, Auckland, New Zealand. Electronic 
      address: spandanaboyana@adhb.govt.nz.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20190312
PL  - Switzerland
TA  - Pancreatology
JT  - Pancreatology : official journal of the International Association of 
      Pancreatology (IAP) ... [et al.]
JID - 100966936
RN  - 0 (MEN1 protein, human)
RN  - 0 (Proto-Oncogene Proteins)
SB  - IM
MH  - *Gene Expression Regulation, Neoplastic
MH  - Humans
MH  - Neuroendocrine Tumors/*metabolism
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/*metabolism
MH  - Proto-Oncogene Proteins/*metabolism
OTO - NOTNLM
OT  - Multiple endocrine neoplasia type 1
OT  - Neuroendocrine tumour
OT  - Surgery
EDAT- 2019/03/22 06:00
MHDA- 2019/12/04 06:00
CRDT- 2019/03/22 06:00
PHST- 2018/11/14 00:00 [received]
PHST- 2019/03/06 00:00 [revised]
PHST- 2019/03/07 00:00 [accepted]
PHST- 2019/03/22 06:00 [pubmed]
PHST- 2019/12/04 06:00 [medline]
PHST- 2019/03/22 06:00 [entrez]
AID - S1424-3903(19)30064-X [pii]
AID - 10.1016/j.pan.2019.03.002 [doi]
PST - ppublish
SO  - Pancreatology. 2019 Apr;19(3):462-471. doi: 10.1016/j.pan.2019.03.002. Epub 2019 
      Mar 12.