Pancreatic endocrine tumors: a large single-center experience

Pancreas. 2009 Nov;38(8):936-40. doi: 10.1097/MPA.0b013e3181b365db.


Objectives: Pancreatic endocrine tumors (PETs) are infrequent, which makes large experiences unlikely. Our aim was to describe a large single-center experience with PETs and the use of endoscopic ultrasound (EUS) and a cancer staging system (TNM).

Methods: This study involves a retrospective analysis of 86 patients (44 men; age, 58 +/- 14 years) who underwent EUS-fine needle aspiration (EUS-FNA). Immunohistochemistry was used. Lesions were classified as recommended by TNM classification.

Results: Typical EUS features were well-demarcated, hypoechoic, solid, homogeneous lesions. Ninety percent had the diagnosis obtained by EUS-FNA. Twelve PETs (14%) were functioning, 8 (9.3%) were cystic, and 14 (16%) were 10 mm or smaller. Nonfunctional PETs and larger lesions were more advanced. The TNM stage was I in 24, II in 10, III in 18, and IV in 34 patients. Sixteen patients (27%) died, and 30 patients (52%) had progression/recurrence during the follow-up (34 +/- 27 months). TNM stage and surgery with curative intent were related to progression. The overall 5-year survival was 60%. The mean survival time was 94 +/- 12 months for stage I, 52 +/- 12 months for stage III, and 54 +/- 7 months for stage IV (P = 0.06).

Conclusions: Nonfunctional PETs were more common and advanced. The EUS-FNA has a high accuracy for diagnosing PETs. Progression and poorer survival were associated with TNM stage.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Fine-Needle
  • Diagnosis, Differential
  • Disease Progression
  • Endosonography
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology*
  • Pancreas / pathology*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Retrospective Studies
  • Survival Analysis
  • Survival Rate