Epidemiology, diagnosis, surgical treatment and prognosis of the pancreatic neuroendocrine tumors: Report of 125 patients from one single center.

OBJECTIVE: The objective of the following study is to summarize the epidemiology of pancreatic neuroendocrine tumors (p‑NETs) in our single institution, analyze the diagnostic characteristics, share the experience of surgical treatments and discuss the prognostic factors. METHODS: A retrospective collection and analysis of clinical data of 125 patients with p‑NETs which were pathologically confirmed in our hospital from January 2002 to December 2012. RESULTS: A total of 125 patients of which 52 were males and 73 were females. Totally 92 patients had functional p‑NETs, while non‑functional p‑NETs were diagnosed in 33 patients. The most common operative procedures performed were local resection of pancreatic tumor (47.2%), followed by distal pancreatectomy (29.6%). Thirty patients (28%) had post‑operative complications, the most common of which was pancreatic fistula (22.4%). The overall survival rate at 5 years was 68.4%. The 5‑year survival rate for patients with functional tumors was 75.1%, compared with 50.0% for those with non‑functional tumors (P = 0.021). The survival time of patients with R0 resection was statistically longer than that of patients with Not R0 resection (P < 0.005). In univariate analysis, the most powerful predictors of poor outcome were gender, age, tumor size, functional status, surgical margins, lymph node invasion and distant metastasis. However only surgical margin and distant metastasis were significant predictors in multivariate analysis (P = 0.001, 0.047, respectively). CONCLUSION: p‑NETs are an uncommon and heterogeneous group of tumors, with a rising incidence. Surgery is the most effective treatment. Surgical margin and distant metastasis were the most significant prognostic factors. Radical resection should be taken more into considerations.