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Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study
Copyright ©The Author(s) 2020.
World J Gastrointest Oncol. Oct 15, 2020; 12(10): 1133-1145
Published online Oct 15, 2020. doi: 10.4251/wjgo.v12.i10.1133
Table 1 Clinicopathological characteristics of resected nonfunctioning pancreatic neuroendocrine tumors
VariableFinding
Age in yr, median (range)56.0 (46.0–63.0)
Male, n (%)51 (46.4)
BMI in kg/m², median (range)24.1 (22.1–26.3)
ASA, grade, n (%)
I30 (27.3)
II59 (53.6)
III21 (19.1)
Diabetes, preoperative, n (%)20 (18.2)
Pancreatic tumor location, n (%)
Head41 (35.7)
Neck6 (5.2)
Body26 (22.6)
Tail42 (36.5)
Type of surgery, n (%)
Distal pancreatectomy51 (46.4)
Enucleation22 (20.0)
Central pancreatectomy7 (6.4)
Pylorus-preservingpancreaticoduodenectomy21 (19.1)
Total pancreatectomy9 (8.2)
MIS or open, n (%)
MIS62 (56.4)
Open48 (43.6)
Post-operative length of stay in d, median (range)11.5 (8.0–17.0)
Clavien-Dindo grade, n (%)
0: no complications58 (52.7)
I35 (31.8)
II8 (7.3)
IIIa5 (4.5)
IIIb3 (2.7)
IVa1 (0.9)
IVb0 (0)
POPF by ISGPF
Grade A47 (40.9%)
Grade B6 (5.2%)
Grade C0 (0%)
DGE by ISGPS
Grade A18 (15.7%)
Grade B1 (0.9%)
Grade C0 (0%)
Resection margin status, n (%)
R097 (88.2)
R15 (4.5)
R28 (7.3)
Pathological tumor size in cm, median (range)1.8 (1.2–3.2)
T stage by ENETS classification
T156 (50.9%)
T218 (16.4%)
T336 (32.7%)
T40 (0.0%)
N status
Negative57 (51.9%)
Positive9 (8.1%)
No lymphadenectomy44 (40.0%)
Metastasis present, n (%)5 (4.5)
2010 WHO classification grade, n (%)
G178 (70.9)
G227 (24.54)
G34 (3.63)
Unknown1 (0.9)
ASA: American Society of Anesthesiologists; BMI: Body mass index; DGE: Delayed gastric emptying; ENETS: European Neuroendocrine Tumor Society; ISGPS: International Study Group on Pancreatic Surgery; ISGPF: International Study Group on Pancreatic Fistula; POPF: Post-operative pancreatic fistulae; WHO: World Health Organization.
Full Size Table
Table 2 Clinicopathological characteristics of minimally invasive and open approaches in terms of the distal location of nonfunctioning pancreatic neuroendocrine tumors
VariableOpen approach, n = 12MIS, n = 39P value
Male7 (58.3%)19 (48.7%)0.801
Age in yr, median (range)58.5 (51.0-64.5)56.0 (47.0-64.5)0.617
BMI in kg/m², median (range)24.6 (22.1-25.5)24.8 (22.9-27.3)0.418
ASA grade, n (%)0.243
I5 (41.7)7 (17.9)
II5 (41.7)23 (59.0)
Ш2 (16.7)9 (23.1)
Spleen-preserving distal pancreatectomy5 (41.7%)26 (66.6%)
Conversion, n (%)-4 (10.2)
Robot-assisted-8 (20.5%)
Operative time as minimum, median (range)179.0 (159.5–251.5)216.0 (185.5–276.0)0.105
Blood loss in cc, median (range)175.0 (65.0–450.0)100 (45.0–275.0)0.093
Clavien-Dindo grade0.729
0: no complications7 (58.3%)26 (66.7%)
I4 (33.3%)10 (25.6%)
II1 (8.3%)2 (5.1%)
IIIa0 (0.0%)1 (2.6%)
DGE by ISGPS0.561
Grade A0 (0.0%)4 (10.3%)
Grade B0 (0.0%)0 (0.0%)
Grade C0 (0.0%)0 (0.0%)
POPF by ISGPF0.805
Grade A7 (58.3%)20 (51.3%)
Grade B0 (0.0%)1 (2.6%)
Grade C0 (0.0%)0 (0.0%)
Post-operative length of stay in d, median (range)14.0 (11.5-16.0)8.0 (7.0-10.5)< 0.001
Resection margin status0.612
R012 (100.0%)36 (92.3%)
R10 (0.0%)2 (5.1%)
R20 (0.0%)1 (2.6%)
Pathological tumor size in cm, median (range)2.5 (1.4-3.9)2.0 (1.5-3.2)0.548
T stage by ENETS classification0.563
T15 (41.7%)20 (51.3%)
T22 (16.7%)9 (23.1%)
T35 (41.7%)10 (25.6%)
N stage0.056
Negative9 (75.0%)38 (97.4%)
Positive3 (25.0%)1 (2.6%)
M stage
012 (100.0%)39 (100.0%)
Nodal harvest, median (range)0.0 (0.0-5.5)1.0 (0.0-3.5)0.767
2010 WHO grade0.365
G17 (57.1%)25 (64.1%)
G24 (42.9%)14 (35.9%)
G31 (8.3%)0 (0%)
ASA: American Society of Anesthesiologists; BMI: Body mass index; DGE: Delayed gastric emptying; ENETS: European Neuroendocrine Tumor Society; ISGPS: International Study Group on Pancreatic Surgery; ISGPF: International Study Group on Pancreatic Fistula; MIS: Minimally invasive surgery; POPF: Post-operative pancreatic fistulae; WHO: World Health Organization.
Full Size Table
Table 3 Clinicopathological characteristics of the minimally invasive surgery and open groups in terms of the proximal location of nonfunctioning pancreatic neuroendocrine tumors
VariableOpen, n = 22MIS, n = 15P value
Male11 (50.0%)5 (33.3%)0.505
Age in yr, median (range)53.5 (40.0–65.0)53.0 (43.0–65.5)0.631
BMI in kg/m², median (range)24.6 (22.7–27.3)21.9 (21.1–23.4)0.006
ASA grade, n (%)0.069
I6 (27.3)0 (0.0)
II14 (63.6)12 (80.0)
III2 (9.1)3 (20.0)
Type of surgery0.541
Central pancreatectomy3 (13.6%)4 (26.7%)
PPPD14 (63.6%)7 (46.7%)
Total pancreatectomy5 (22.7%)4 (26.7%)
Operative time in min, median (range)346.0 (295.0-400.0)512.0 (462.5-530.0)< 0.001
Blood loss in cc, median (range)450.0 (100.0-1020.0)400. (175.0-450.0)0.515
Clavien-Dindo grade0.489
0: no complications10 (45.5%)4 (26.7%)
I8 (36.4%)5 (33.3%)
II1 (4.5%)3 (20.0%)
IIIa1 (4.5%)1 (6.7%)
IIIb2 (9.1%)1 (6.7%)
IV0 (0.0%)1 (6.7%)
DGEby ISGPS0.457
Grade A7 (31.8%)5 (33.3%)
Grade B0 (0.0%)1 (6.7%)
Grade C0 (0.0%)0 (0.0%)
POPF by ISGPF0.571
Grade A5 (22.7%)4 (26.7%)
Grade B1 (4.5%)2 (13.3%)
Grade C0 (0.0%)0 (0.0%)
Post-operative length of stay in d, median (range)20.0 (14.0–30.0)13.0 (10.5–24.5)0.210
Resection margin status0.505
R020 (90.9%)15 (100.0%)
R10 (0.0%)0 (0.0%)
R22 (9.1%)0 (0.0%)
Pathological tumor size incm, median (range)2.6 (1.5-4.5)1.5 (1.3-2.2)0.041
T stage by ENETs classification0.081
T16 (27.3%)8 (53.3%)
T25 (22.7%)0 (0.0%)
T311 (50.0%)7 (46.7%)
N stage1.000
020 (90.9%)13 (86.7%)
12 (9.1%)2 (13.3%)
M stage1.000
019 (86.4%)13 (86.7%)
13 (13.6%)2 (13.3%)
Nodal harvest, median (range)7.5 (5-12)6.0 (2.5-12.5)0.804
2010 WHO grade0.848
G116 (72.7%)10 (66.7%)
G23 (13.6%)4 (26.7%)
G32 (9.1%)1 (6.7%)
Unknown1 (4.5%)0 (0%)
ASA: American Society of Anesthesiologists; BMI: Body mass index; DGE: Delayed gastric emptying; ENETS: European Neuroendocrine Tumour Society; ISGPS: International Study Group on Pancreatic Surgery; ISGPF: International Study Group on Pancreatic Fistula; MIS: Minimally invasive surgery; POPF: Post-operative pancreatic fistulae; PPPD: Pylorus-preserving pancreaticoduodenectomy; WHO: World Health Organization.
Full Size Table
Table 4 Factors associated with tumor recurrence after curative resection of nonfunctioning pancreatic neuroendocrine tumors
VariableUnivariate analysis
Multivariate analysis
HR95%CIP valueHR95%CIP value
Age > 60 yr0.400.09-1.830.239
Male1.950.62-6.160.254
Minimally invasive surgery0.610.18-2.090.4321.0620.28-4.030.929
Tumor size > 2.5 cm22.212.86-172.690.00316.211.99-128.80.009
Positive resection margin1.520.33–6.990.589
Poor differentiation, G371.556.43-795.750.00124.4291.99-277.950.017
Positive lymph node1.930.42–8.830.398
Lympho-vascular invasion8.772.75-27.93< 0.0013.560.96-13.20.058
HR: Hazard ratio.
Full Size Table
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