Genc CG, et al. - Researchers performed a nationwide population-based study on the survival of patients with pancreatic neuroendocrine tumors in the Netherlands. For all pancreatic neuroendocrine tumors (pNETs) tumors, surgical resection demonstrated favorable outcome, including indolent tumors and tumors with distant metastases. To confirm these results, they recommend conducting prospective trials.

Methods

• From 2008 to 2013, researchers included patients diagnosed with pNET from the Netherlands Cancer Registry.
• They documented patient, tumors and treatment characteristics.
• To compare survival, they performed survival analyses with log-rank testing.

Results

• In total, this study included 611 patients.
• Median follow-up 25.7 months was performed; all-cause mortality was 42%.
• In both the overall and metastasized population, higher tumor grade and TNM stage indicated a significant association with worse survival.
• In lower tumor stages (T1–3 p < 0.05, T4 p = 0.074), the effect of distant metastases on survival was more marked. 255 (42%) patients underwent resection of the primary tumor.
• Highest 5-year survival was evident for patients who underwent surgery (86%) compared to PRRT (33%), chemotherapy (21%), targeted therapy and somatostatin analogs (24%) (all p < 0.001).
• Compared to no therapy, patients with T1M0 tumors (n = 115) indicated favorable survival after surgical resection (N = 95) (N = 20, p = 0.008).
• In this study, resection also improved survival significantly in patients with metastases compared to other treatments (all p > 0.05).
• Without surgery, in patients with distant metastases, PRRT indicated the best survival curves.
• There appeared an independent association of Grade 3 tumors and surgical resection with survival (HR 7.23 and 0.12, respectively).