Pancreatic neuroendocrine tumors. Surgical outcomes and overall survival

Background: Pancreatic neuroendocrine tumors (PNET) account for 1-2% of pancreatic neoplasms. Its incidence has increased in recent years probably due to improved imaging studies. Aim: To analyze the clinical characteristics, surgical outcomes and overall survival of patients with PNET who underwent resective surgery. Methods: Case series study. Data was collected from the central database and clinical records from patients with biopsy-proven PNET's who underwent surgical resection from June 2005 to June 2012. Results: Twenty patients were included (10.6% of all pancreatic resections), 12 female, with a median age of 44 [20-77] years. Abdominal pain was the most common symptom. Two patients had a type 1 multiple endocrine neoplasia (MEN-1) syndrome. Pre-operative work up included CT, MR and/or PET/CT. Five patients had functional tumors. Five Whipple procedures, 14 distal pancreatectomies and 1 enucleation were performed. Among the postoperative complications, there were 5 type B and 1 type C pancreatic fistulas. There was no mortality. At 31 [5-90] month median follow-up, overall survival was 100%. Conclusion: PNETs represent an increasing reason for pancreatic resection in our center. Surgical resection of the tumor with negative microscopic margins is the treatment of choice.