Evaluation of Survival Following Surgical Resection for Small Nonfunctional Pancreatic Neuroendocrine Tumors
Authors' conclusion
Findings of this study support an association between surgical resection and increased survival in select patients with NF-PanNETs measuring 1.1 to 2.0 cm who were younger than 65 years, had no comorbidities, received treatment at academic institutions, and had tumors of the distal pancreas. Future investigations of surgical resection for small NF-PanNETs that include the Ki-67 index are warranted to validate these findings.
Study context
- Population
- Patients with nonfunctional pancreatic NET ≤2 cm (group 1a ≤1 cm; group 1b 1.1–2.0 cm) diagnosed 2004–2017, National Cancer Database; mean (SD) age 60.5 (12.7) years, 50.4% malesof 10,504 identified
- Participants
- 4,641 patients
- Exposure
- Surgical resection vs no surgical resection
- Outcome
- Overall survival with vs without surgical resection, in group 1a or group 1b (multivariable Cox models)
- Follow-up
- Median (IQR) 47.1 (28.2-71.6) months
Methodological detailsNational Cancer Database
- National Cancer Database
Main finding
As reported in the abstract
Overall survival, adjusted for preoperative factors (subgroups by tumor size)
HR for death (95% CI)P value
Resection, group 1b (1.1-2.0 cm)vs No resection, group 1blonger survival with resection
0.58(0.42–0.80)
P < 0.001Resection, group 1a (≤1 cm)vs No resection, group 1anot associated with longer survival
0.68(0.41–1.11)
P = 0.12Observational data: associations, not effects.
Further findings
Surgical resection rates
- Group 1a
- 82.0%
- Group 1b
- 87.0%
Interaction analysis in group 1b
- Age ≤64 years, no comorbidities, treatment at academic institutions and distal pancreatic tumors associated with increased survival after surgical resection
Original publication
Evaluation of Survival Following Surgical Resection for Small Nonfunctional Pancreatic Neuroendocrine Tumors. JAMA Netw Open. Published 1 March 2023. doi:10.
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