Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study
Objective To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain. Methods Incidentally discovered, spora...
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| Veröffentlicht in: | Annals of surgical oncology 2016-04, Vol.23 (4), p.1361-1370 |
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| container_title | Annals of surgical oncology |
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| creator | Sadot, Eran Reidy-Lagunes, Diane L. Tang, Laura H. Do, Richard Kinh Gian Gonen, Mithat D’Angelica, Michael I. DeMatteo, Ronald P. Kingham, T. Peter Koerkamp, Bas Groot Untch, Brian R. Brennan, Murray F. Jarnagin, William R. Allen, Peter J. |
| description | Objective
To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain.
Methods
Incidentally discovered, sporadic, small ( |
| doi_str_mv | 10.1245/s10434-015-4986-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1770217159</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3973588711</sourcerecordid><originalsourceid>FETCH-LOGICAL-c481t-aa316cf86f088b8f297b81374943539b290f7d6aa75b5a576a00da52c9b5521a3</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0Eohd4gG4qS2zYBHyS-NbdaAQFqdCKlrXlOCdlqiSe-iSVZsc78IY8CZ5OQRVSVz76_Z3flj7GjkC8g7KW7wlEXdWFAFnU1qgCnrF9kDmplYHneRbKFLZUco8dEN0IAboS8iXby5HVlZL7bDpvCNOdn1Zx5HeYaCb-DQnDfdDFxC8H3_d8QZthPcUhg4Ff-DEkvB-_4pwijm0MaTUiv5qHmOiEL_gXP4Uf2PKlJ_z989cyjlOKPb-c5nbzir3ofE_4-uE8ZN8_frhafirOzk8_LxdnRagNTIX3FajQGdUJYxrTlVY3Bipd27qSlW1KKzrdKu-1bKSXWnkhWi_LYBspS_DVIXu7612neDsjTW5YUcC-9yPGmRxoLUrQIG1G3_yH3sQ5jfl3WwpASLAqU7CjQopECTu3TqvBp40D4bZK3E6Jy0rcVomDvHP80Dw3A7b_Nv46yEC5AyhfjdeYHj39ZOsfD2mXzw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1771105196</pqid></control><display><type>article</type><title>Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Sadot, Eran ; Reidy-Lagunes, Diane L. ; Tang, Laura H. ; Do, Richard Kinh Gian ; Gonen, Mithat ; D’Angelica, Michael I. ; DeMatteo, Ronald P. ; Kingham, T. Peter ; Koerkamp, Bas Groot ; Untch, Brian R. ; Brennan, Murray F. ; Jarnagin, William R. ; Allen, Peter J.</creator><creatorcontrib>Sadot, Eran ; Reidy-Lagunes, Diane L. ; Tang, Laura H. ; Do, Richard Kinh Gian ; Gonen, Mithat ; D’Angelica, Michael I. ; DeMatteo, Ronald P. ; Kingham, T. Peter ; Koerkamp, Bas Groot ; Untch, Brian R. ; Brennan, Murray F. ; Jarnagin, William R. ; Allen, Peter J.</creatorcontrib><description>Objective
To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain.
Methods
Incidentally discovered, sporadic, small (<3 cm), stage I–II PanNET were analyzed retrospectively between 1993 and 2013. Diagnosis was determined either by pathology or imaging characteristics. Intention-to-treat analysis was applied.
Results
A total of 464 patients were reviewed. Observation was recommended for 104 patients (observation group), and these patients were matched to 77 patients in the resection group based on tumor size at initial imaging. The observation group was significantly older (median 63 vs. 59 years,
p
= 0.04) and tended towards shorter follow-up (44 vs. 57 months,
p
= 0.06). Within the observation group, 26 of the 104 patients (25 %) underwent subsequent tumor resection after a median observation interval of 30 months (range 7–135). At the time of last follow-up of the observation group, the median tumor size had not changed (1.2 cm,
p
= 0.7), and no patient had developed evidence of metastases. Within the resection group, low-grade (G1) pathology was recorded in 72 (95 %) tumors and 5 (6 %) developed a recurrence, which occurred after a median of 5.1 (range 2.9–8.1) years. No patient in either group died from disease. Death from other causes occurred in 11 of 181 (6 %) patients.
Conclusions
In this study, no patient who was initially observed developed metastases or died from disease after a median follow-up of 44 months. Observation for stable, small, incidentally discovered PanNET is reasonable in selected patients.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-015-4986-1</identifier><identifier>PMID: 26597365</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Case-Control Studies ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Neuroendocrine Tumors - pathology ; Neuroendocrine Tumors - surgery ; Oncology ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Pancreatic Tumors ; Patient Selection ; Prognosis ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival Rate ; Watchful Waiting</subject><ispartof>Annals of surgical oncology, 2016-04, Vol.23 (4), p.1361-1370</ispartof><rights>Society of Surgical Oncology 2015</rights><rights>Society of Surgical Oncology 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-aa316cf86f088b8f297b81374943539b290f7d6aa75b5a576a00da52c9b5521a3</citedby><cites>FETCH-LOGICAL-c481t-aa316cf86f088b8f297b81374943539b290f7d6aa75b5a576a00da52c9b5521a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-015-4986-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-015-4986-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26597365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sadot, Eran</creatorcontrib><creatorcontrib>Reidy-Lagunes, Diane L.</creatorcontrib><creatorcontrib>Tang, Laura H.</creatorcontrib><creatorcontrib>Do, Richard Kinh Gian</creatorcontrib><creatorcontrib>Gonen, Mithat</creatorcontrib><creatorcontrib>D’Angelica, Michael I.</creatorcontrib><creatorcontrib>DeMatteo, Ronald P.</creatorcontrib><creatorcontrib>Kingham, T. Peter</creatorcontrib><creatorcontrib>Koerkamp, Bas Groot</creatorcontrib><creatorcontrib>Untch, Brian R.</creatorcontrib><creatorcontrib>Brennan, Murray F.</creatorcontrib><creatorcontrib>Jarnagin, William R.</creatorcontrib><creatorcontrib>Allen, Peter J.</creatorcontrib><title>Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Objective
To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain.
Methods
Incidentally discovered, sporadic, small (<3 cm), stage I–II PanNET were analyzed retrospectively between 1993 and 2013. Diagnosis was determined either by pathology or imaging characteristics. Intention-to-treat analysis was applied.
Results
A total of 464 patients were reviewed. Observation was recommended for 104 patients (observation group), and these patients were matched to 77 patients in the resection group based on tumor size at initial imaging. The observation group was significantly older (median 63 vs. 59 years,
p
= 0.04) and tended towards shorter follow-up (44 vs. 57 months,
p
= 0.06). Within the observation group, 26 of the 104 patients (25 %) underwent subsequent tumor resection after a median observation interval of 30 months (range 7–135). At the time of last follow-up of the observation group, the median tumor size had not changed (1.2 cm,
p
= 0.7), and no patient had developed evidence of metastases. Within the resection group, low-grade (G1) pathology was recorded in 72 (95 %) tumors and 5 (6 %) developed a recurrence, which occurred after a median of 5.1 (range 2.9–8.1) years. No patient in either group died from disease. Death from other causes occurred in 11 of 181 (6 %) patients.
Conclusions
In this study, no patient who was initially observed developed metastases or died from disease after a median follow-up of 44 months. Observation for stable, small, incidentally discovered PanNET is reasonable in selected patients.</description><subject>Aged</subject><subject>Case-Control Studies</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Neuroendocrine Tumors - surgery</subject><subject>Oncology</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreatic Tumors</subject><subject>Patient Selection</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Watchful Waiting</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kctu1DAUhi0Eohd4gG4qS2zYBHyS-NbdaAQFqdCKlrXlOCdlqiSe-iSVZsc78IY8CZ5OQRVSVz76_Z3flj7GjkC8g7KW7wlEXdWFAFnU1qgCnrF9kDmplYHneRbKFLZUco8dEN0IAboS8iXby5HVlZL7bDpvCNOdn1Zx5HeYaCb-DQnDfdDFxC8H3_d8QZthPcUhg4Ff-DEkvB-_4pwijm0MaTUiv5qHmOiEL_gXP4Uf2PKlJ_z989cyjlOKPb-c5nbzir3ofE_4-uE8ZN8_frhafirOzk8_LxdnRagNTIX3FajQGdUJYxrTlVY3Bipd27qSlW1KKzrdKu-1bKSXWnkhWi_LYBspS_DVIXu7612neDsjTW5YUcC-9yPGmRxoLUrQIG1G3_yH3sQ5jfl3WwpASLAqU7CjQopECTu3TqvBp40D4bZK3E6Jy0rcVomDvHP80Dw3A7b_Nv46yEC5AyhfjdeYHj39ZOsfD2mXzw</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Sadot, Eran</creator><creator>Reidy-Lagunes, Diane L.</creator><creator>Tang, Laura H.</creator><creator>Do, Richard Kinh Gian</creator><creator>Gonen, Mithat</creator><creator>D’Angelica, Michael I.</creator><creator>DeMatteo, Ronald P.</creator><creator>Kingham, T. Peter</creator><creator>Koerkamp, Bas Groot</creator><creator>Untch, Brian R.</creator><creator>Brennan, Murray F.</creator><creator>Jarnagin, William R.</creator><creator>Allen, Peter J.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160401</creationdate><title>Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study</title><author>Sadot, Eran ; Reidy-Lagunes, Diane L. ; Tang, Laura H. ; Do, Richard Kinh Gian ; Gonen, Mithat ; D’Angelica, Michael I. ; DeMatteo, Ronald P. ; Kingham, T. Peter ; Koerkamp, Bas Groot ; Untch, Brian R. ; Brennan, Murray F. ; Jarnagin, William R. ; Allen, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-aa316cf86f088b8f297b81374943539b290f7d6aa75b5a576a00da52c9b5521a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Case-Control Studies</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Neuroendocrine Tumors - surgery</topic><topic>Oncology</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreatic Tumors</topic><topic>Patient Selection</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Watchful Waiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sadot, Eran</creatorcontrib><creatorcontrib>Reidy-Lagunes, Diane L.</creatorcontrib><creatorcontrib>Tang, Laura H.</creatorcontrib><creatorcontrib>Do, Richard Kinh Gian</creatorcontrib><creatorcontrib>Gonen, Mithat</creatorcontrib><creatorcontrib>D’Angelica, Michael I.</creatorcontrib><creatorcontrib>DeMatteo, Ronald P.</creatorcontrib><creatorcontrib>Kingham, T. Peter</creatorcontrib><creatorcontrib>Koerkamp, Bas Groot</creatorcontrib><creatorcontrib>Untch, Brian R.</creatorcontrib><creatorcontrib>Brennan, Murray F.</creatorcontrib><creatorcontrib>Jarnagin, William R.</creatorcontrib><creatorcontrib>Allen, Peter J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sadot, Eran</au><au>Reidy-Lagunes, Diane L.</au><au>Tang, Laura H.</au><au>Do, Richard Kinh Gian</au><au>Gonen, Mithat</au><au>D’Angelica, Michael I.</au><au>DeMatteo, Ronald P.</au><au>Kingham, T. Peter</au><au>Koerkamp, Bas Groot</au><au>Untch, Brian R.</au><au>Brennan, Murray F.</au><au>Jarnagin, William R.</au><au>Allen, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>23</volume><issue>4</issue><spage>1361</spage><epage>1370</epage><pages>1361-1370</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Objective
To analyze the natural history of small asymptomatic pancreatic neuroendocrine tumors (PanNET) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small PanNET is uncertain.
Methods
Incidentally discovered, sporadic, small (<3 cm), stage I–II PanNET were analyzed retrospectively between 1993 and 2013. Diagnosis was determined either by pathology or imaging characteristics. Intention-to-treat analysis was applied.
Results
A total of 464 patients were reviewed. Observation was recommended for 104 patients (observation group), and these patients were matched to 77 patients in the resection group based on tumor size at initial imaging. The observation group was significantly older (median 63 vs. 59 years,
p
= 0.04) and tended towards shorter follow-up (44 vs. 57 months,
p
= 0.06). Within the observation group, 26 of the 104 patients (25 %) underwent subsequent tumor resection after a median observation interval of 30 months (range 7–135). At the time of last follow-up of the observation group, the median tumor size had not changed (1.2 cm,
p
= 0.7), and no patient had developed evidence of metastases. Within the resection group, low-grade (G1) pathology was recorded in 72 (95 %) tumors and 5 (6 %) developed a recurrence, which occurred after a median of 5.1 (range 2.9–8.1) years. No patient in either group died from disease. Death from other causes occurred in 11 of 181 (6 %) patients.
Conclusions
In this study, no patient who was initially observed developed metastases or died from disease after a median follow-up of 44 months. Observation for stable, small, incidentally discovered PanNET is reasonable in selected patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>26597365</pmid><doi>10.1245/s10434-015-4986-1</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2016-04, Vol.23 (4), p.1361-1370 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Case-Control Studies Cross-Sectional Studies Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Neuroendocrine Tumors - pathology Neuroendocrine Tumors - surgery Oncology Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Pancreatic Tumors Patient Selection Prognosis Retrospective Studies Surgery Surgical Oncology Survival Rate Watchful Waiting |
| title | Observation versus Resection for Small Asymptomatic Pancreatic Neuroendocrine Tumors: A Matched Case–Control Study |
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