Comparison of Oncological and Surgical Outcomes Between Formal Pancreatic Resections and Parenchyma-Sparing Resections for Small PanNETs ( Antonio Pea  1 , Lulu Tanno  2 , Taina Nykänen  3 , Pooja Prasad  4 , Ceren Tunçer  5 , Stuart Robinson  4 , Giovanni Marchegiani  1 Affiliations Expand Affiliations 1 Department of Surgery, Istituto Pancreas, Ospedale Universitario Integrato Verona, Verona, Italy. 2 Department of General Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. 3 Department of Surgery, Hyvinaa Hospital, Hyvinkaa, Finland. 4 Freeman Hospital, Newcastle upon Tyne, United Kingdom. 5 School of Medicine, Koc University Research Centre for Translational Medicine, Istanbul, Turkey. PMID: 33015105 PMCID: PMC7511698 DOI: 10.3389/fmed.2020.00559 Free PMC article Item in Clipboard

Antonio Pea, Lulu Tanno, Taina Nykänen, Pooja Prasad, Ceren Tunçer, Stuart Robinson, Giovanni Marchegiani, Antonio Pea, Lulu Tanno, Taina Nykänen, Pooja Prasad, Ceren Tunçer, Stuart Robinson, Giovanni Marchegiani

Abstract

Pancreatic neuroendocrine tumors (PanNETs) are rare tumors but incidence is increasing. An increasing number of these tumors are diagnosed incidentally when they are small (<2 cm) and when patients are asymptomatic. The European Neuroendocrine Tumor Society (ENETS) recommends conservative watch and wait policy for these patients. However, best surgical approach (parenchyma-sparing or formal oncological resection) for these small tumors when surgery is indicated is currently unknown. Parenchyma-sparing resections such as enucleation is associated with higher risk of post-operative morbidity compared to formal oncological resections. They are also be associated with potentially inadequate surgical margin clearance and with lack of lymphadenectomy for full pathological staging. Method: This study is a retrospective study and the aim is to analyze pre-operative clinical predictors of nodal metastases for small PanNETs to identify which patients are at a lower risk of lymph node metastases and are therefore suitable for parenchyma-sparing resection. Conclusion: The primary endpoint of this study is to determine if pre-operative clinical predictors such as tumor size are associated with lymph node involvement in small PanNETs.

Keywords: oncological outcomes; pancreatic neurendocrine tumor; pancreatic resection; parenchyma sparing pancreatectomy; survival.

Copyright © 2020 Pea, Tanno, Nykänen, Prasad, Tunçer, Robinson and Marchegiani.

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