Pancreatic neuroendocrine tumors

Introduction: Part of neuroendocrine tumors among all pancreatic cancers is from 2% to 4%. Pancreatic neuroendocrine tumors are a group of heterogeneous lesions with a variety of clinical symptoms and different prognosis. Data about clinical, surgical and pathological results of treatment of patients with pancreatic neuroendocrine tumors is presented in this study. We have analyzed prognostic factors and effectiveness of surgical treatment in patients with pancreatic neuroendocrine tumors. Methods: The retrospective analysis of 82 patients with diagnosis “pancreatic neuroendocrine tumor” who were treated surgically in the National Cancer Institute, Kyiv, Ukraine, between 1997-2017 years was performed. Results: According to localization of tumor, patients underwent the following surgical interventions: pancreatoduodenal resection in 23 (28.1%) patients, distal pancreatectomy in 31 (37.8%), 6 distal pancreatectomies were performed laparoscopically, distal pancreatectomy without splenectomy – in 17 (20.7%), 11 (13.4%) patients undergone explorative interventions due to unresectable distant metastases. In 20 (24.3%) patients, who have resectable distant liver metastases, liver resection was performed. 8 (9.7%) patients with distant lung metastases undergone simultaneous metastasectomy and in 2 (2.4%) cases combined resection of liver and lung was performed. R0-resection was achieved in 73 (89.1%) patients, R1 – in 9 (10.9%) patients accordingly. Postoperative complications were registered in 22 (26.8%) patients. Among them 17 (77.3%) were mild. Overall 5-year postoperative survival rate was 86.6%. Statistical difference in survival significantly correlated with stage of disease (p = 0.0002). Overall survival was significantly longer in the group of patients with functioning tumors (p = 0.039). Comparison of distant results of survival in patients with metastases on pancreatic neuroendocrine tumor showed that patients who were treated surgically had higher overall survival than patients who received conservative therapy (p < 0.001). Conclusion: Despite the heterogeneity of biological factors of pancreatic neuroendocrine tumors, surgery remains the leading method of treatment, which significantly prolongs patients’ lifetime. Performance of combined surgeries in patients with metastatic pancreatic neuroendocrine tumors, including resection of primary tumor greatly improve distant results of treatment compared with the group receiving conservative treatment.