PANCREATIC NEUROENDOCRINE TUMORS: RESULTS OF THE LAST DECADE markogiannakis@yahoo.com

PW06-04

PANCREATIC NEUROENDOCRINE TUMORS: RESULTS OF THE LAST DECADE

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Greece

Oral or Poster

Our objective was to analyze pancreatic neuroendocrine tumor (pNET) cases operated during the last decade.

Data of all patients operated due to pNETs are prospectively collected.

Thirty cases were enrolled (female: 60%, age: 58±6.5 years). Diagnosis was: single non-functioning tumor (63.3%), insulinoma (26.7%), multiple non-functioning tumors (6.7%, MENI syndrome) and gastrinoma (3.3%). Computed tomography depicted the lesion in 93.3%, MRI 96.3% and EUS in 100%. The tumor was located in the pancreatic head in 33.3%, body 30%, tail 30% and throughout the pancreas in 6.7%. Distal pancreatectomy with splenectomy was performed in 40%, Whipple 33.3%, distal pancreatectomy without splenectomy 13.3%, enucleation 10% and total pancreatectomy in 3.3%. Twelve patients (40%) suffered from postoperative complications: pancreatic fistula (20%), intrabdominal collection (6.7%), postoperative hemorrhage (6.7%, necessitating reoperation), splenic infarct (3.3%), and delayed gastric emptying (3.3%). Mean tumor diameter was 3.3±1.2 cm. Tumors were G1 stage in 50%, G2 % 26.7% and G3 23.3%. Capsule infiltration was identified in 33.3%, perineural invasion 16.7%, perivascular invasion 13.3%, and lymph vessel infarct in 6.7%. Lymph node dissection was performed in 73.3% and involvement was identified in 31.8% of the dissection cases (23.3% of the total group). Regarding immunohistochemistry, chromogranin-A was positive in 96.7%, synaptophysin 93.3%, NSE 93.3%, CD56 86.7% and CK8/18 in 86.7%. During the short follow-up period of 64.8±8.3 months no recurrence has occurred so far.

Pancreatic NETs are rare tumors that need a multidisciplinary approach. Their surgical management is challenging and demanding. An important proportion of such neoplasms may show aggressive characteristics.