A Single Centre Analysis of Clinical Characteristics and Treatment of Endocrine Pancreatic Tumours.

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2015-01-01 Epub Date: 2015-06-08 DOI:10.1155/2015/538948
M T Adil, R Nagaraja, V Varma, N Mehta, V Kumaran, S Nundy
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引用次数: 4

Abstract

Background. Endocrine Pancreatic Tumours (PENs) are rare and can be nonfunctioning or functioning. They carry a good prognosis overall though high grade lesions show a relatively shorter survival. The aim of the current study is to describe a single centre analysis of the clinical characteristics and surgical treatment of PENs. Patients and Methods. This is a cohort analysis of 40 patients of PENs who underwent surgery at Sir Ganga Ram Hospital, New Delhi, India, from 1995 to 2013. Patient particulars, clinical features, surgical interventions, postoperative outcome, and followup were done and reviewed. The study group was divided based on grade (G1, G2, and G3) and functionality (nonfunctioning versus functioning) for comparison. Results. PENs comprised 6.3% of all pancreatic neoplasms (40 of 634). Twenty-eight patients (70%) had nonfunctioning tumours. Eighteen PENs (45%) were carcinomas (G3), all of which were nonfunctioning. 14 (78%) of these were located in the pancreatic head and uncinate process (P = 0.09). The high grade (G3) lesions were significantly larger in size than the lower grade (G1 + G2) tumours (7.0 ± 3.5 cms versus 3.1 ± 1.6 cms, P = 0.007). Pancreatoduodenectomy was performed in 18 (45%), distal pancreatectomy in 10 (25%), and local resection in 8 (20%) and nonresective procedures were performed in 4 patients (10%). Fourteen patients (35%) had postoperative complications. All G3 grade tumours which were resected had positive lymph nodes (100%) and 10 had angioinvasion (71%). Eight neoplasms (20%) were cystic, all being grade G3 carcinomas, while the rest were solid. The overall disease related mortality attributable to PEN was 14.3% (4 of 28) and for malignant PENs was 33.3% (4 of 12) after a mean follow-up period of 49.6 months (range: 2-137 months). Conclusion. Majority of PENs are nonfunctioning. They are more likely malignant if they are nonfunctioning and large in size, show cystic appearance, and are situated in the pancreatic head. Early surgery leads to good long term survival with acceptable postoperative morbidity.

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胰腺内分泌肿瘤临床特点及治疗的单中心分析。
背景。胰腺内分泌肿瘤(钢笔)是罕见的,可以是无功能或功能。它们总体预后良好,尽管高级别病变的生存期相对较短。本研究的目的是对pen的临床特征和手术治疗进行单中心分析。患者和方法。这是一项对1995年至2013年在印度新德里Sir Ganga Ram医院接受手术的40例pen患者的队列分析。对患者资料、临床特征、手术干预、术后结果和随访进行了回顾。研究组根据分级(G1、G2和G3)和功能(无功能与功能)进行分组进行比较。结果。PENs占所有胰腺肿瘤的6.3%(634例中有40例)。28例患者(70%)存在无功能肿瘤。18例(45%)为癌(G3),均无功能。其中14例(78%)位于胰头和钩突(P = 0.09)。高分级(G3)肿瘤的大小明显大于低分级(G1 + G2)肿瘤(7.0±3.5 cms vs 3.1±1.6 cms, P = 0.007)。18例(45%)行胰十二指肠切除术,10例(25%)行远端胰切除术,8例(20%)行局部切除术,4例(10%)行非切除术。术后并发症14例(35%)。所有切除的G3级肿瘤均有淋巴结阳性(100%),10例有血管浸润(71%)。8例(20%)为囊性,均为G3级癌,其余为实性癌。平均随访时间为49.6个月(范围:2-137个月),由PEN引起的总体疾病相关死亡率为14.3%(28 / 4),恶性PEN的死亡率为33.3%(12 / 4)。结论。大多数钢笔都不能正常工作。如果它们没有功能,体积大,呈囊状,位于胰腺头部,则更有可能是恶性的。早期手术可导致良好的长期生存和可接受的术后发病率。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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