Ideal outcome after pancreatic resection for neuroendocrine tumors: a nationwide study.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Hpb Pub Date : 2025-01-07 DOI:10.1016/j.hpb.2024.12.024

Jeffrey W Chen, Simone A Augustinus, Bert A Bonsing, Stefan A W Bouwense, Ignace H J T De Hingh, Casper H Van Eijck, Bas Groot Koerkamp, Tessa E Hendriks, Anton F Engelsman, Marc G Besselink, Els J M Nieveen van Dijkum

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Abstract

Background: Pancreatic resections for pancreatic neuroendocrine tumors (pNET) may experience a higher complication rate than for pancreatic ductal adenocarcinoma (PDAC). This study aimed to determine the rate of the novel composite "Ideal Outcome" measure after resection for pNET, using PDAC as reference.

Methods: This observational cohort study included all consecutive patients after pancreatic resection for pNET and PDAC using the nationwide Dutch Pancreatic Cancer Audit (2014-2021). The primary outcome was Ideal Outcome; absence of postoperative mortality, postoperative pancreatic fistulas (POPF) grade B/C, other major complications, prolonged length of stay, reoperations and readmissions.

Results: In total, 524 pNET and 2851 PDAC resections were included. The rate of Ideal Outcome was lower after resection for pNET (47.7% versus 55.7%; P<0.001) as compared to PDAC. This difference was driven by a lower rate of Ideal Outcome after pancreatoduodenectomy for pNET (37.7% versus 56.3%; P<0.001), with no difference after left pancreatectomy (54.5% versus 52.5%; P=0.598). Among the individual components of Ideal Outcome after pancreatoduodenectomy, the largest difference was a four times higher rate of POPF (32.1% versus 7.9%; P<0.001) after resection of pNET.

Conclusion: Patients undergoing pancreatoduodenectomy for pNET have a reduced Ideal Outcome rate compared to patients with PDAC, related to a fourfold increased risk of POPF. This highlights the value of pNET-specific patient counseling and the need for effective POPF mitigation strategies.

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胰腺切除术治疗神经内分泌肿瘤的理想预后：一项全国性研究。

背景：胰腺神经内分泌肿瘤（pNET）切除术可能比胰腺导管腺癌（PDAC）有更高的并发症发生率。本研究旨在确定pNET切除术后新型复合“理想预后”测量的比率，以PDAC为参考。方法：本观察性队列研究纳入了荷兰全国胰腺癌审计（2014-2021）中因pNET和PDAC进行胰腺切除术后的所有连续患者。主要结局为理想结局；无术后死亡率、术后胰瘘（POPF） B/C级、其他主要并发症、住院时间延长、再手术和再入院。结果：共纳入524例pNET和2851例PDAC切除术。pNET切除术后理想预后率较低(47.7%比55.7%；结论：与PDAC患者相比，接受胰十二指肠切除术的pNET患者的理想转归率降低，与POPF风险增加4倍相关。这突出了pnet特异性患者咨询的价值以及有效的POPF缓解策略的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).