Prediction of disease recurrence in patients after complete pancreatic NET (PanNET) G2 resection.

Helena Olearska, Anna Sowa-Staszczak, Karolina Morawiec-Sławek, Anna Kurzyńska, Magdalena Kolasa, Edyta Tkacz, Małgorzata Szumińska, Alicja Hubalewska-Dydejczyk, Marta Opalinska
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Abstract

Introduction: The number of detected pancreatic neuroendocrine tumours (PanNETs) has been increasing over the last decades. Surgical resection remains the only potentially curative treatment, but the management is still controversial. This study aimed to compare patients after radical PanNET G2 resection to determine the most important predictive factors for relapse.

Material and methods: All patients with histologically confirmed PanNET G2 who underwent successful surgery between 2006 and 2020 with the intention of radical treatment were enrolled.

Results: In total, 44 patients were eligible for the analysis. The average follow-up was 8.39 ± 4.5 years. Disease recurrence was observed in 16 (36.36%) patients. The dominant location of the primary tumour was the tail of the pancreas (43.18%), especially in the subgroup with disease recurrence (56.25%). The smallest tumour diameter associated with the PanNET G2 recurrence was 22 mm. The relationship between the largest dimension of the tumour with a division of < 4 cm vs. > 4 cm and the relapse was close to statistical significance. Recurrence was associated with a larger tumour size (p = 0.018). There was a statistically significant relationship and a weak correlation between Ki-67 (p = 0.036, V Cramer = 0.371) and disease relapse.

Conclusion: For the group of PanNET G2 patients after radical surgery, the overall risk of recurrence was 36.36%, with the highest rate in the first 5 years after surgery, but in individual cases it occurred significantly later, even 10 years after surgery. The most important predictive factors of the PanNET G2 recurrence was Ki-67 over 5.75% and size of tumour > 4 cm.

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胰腺 NET (PanNET) G2 完全切除术后患者疾病复发的预测。
简介过去几十年来,胰腺神经内分泌肿瘤(PanNETs)的发病率不断上升。手术切除仍是唯一可能治愈的治疗方法,但在治疗方法上仍存在争议。本研究旨在比较 PanNET G2 根治性切除术后的患者,以确定预测复发的最重要因素:所有在2006年至2020年间接受根治性治疗并成功接受手术的组织学确诊PanNET G2患者均被纳入研究:结果:共有44名患者符合分析条件。平均随访时间为 8.39 ± 4.5 年。16例(36.36%)患者出现疾病复发。原发肿瘤的主要位置是胰腺尾部(43.18%),尤其是在疾病复发的亚组(56.25%)中。与 PanNET G2 复发相关的最小肿瘤直径为 22 毫米。肿瘤最大直径小于 4 厘米与大于 4 厘米与复发之间的关系接近统计学意义。复发与肿瘤尺寸较大有关(p = 0.018)。Ki-67(p = 0.036,V Cramer = 0.371)与疾病复发之间存在统计学意义上的显著关系和弱相关性:对于根治术后的 PanNET G2 患者组,总复发风险为 36.36%,术后头 5 年的复发率最高,但个别病例的复发时间明显较晚,甚至出现在术后 10 年。PanNET G2复发的最重要预测因素是Ki-67超过5.75%和肿瘤大小大于4厘米。
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