Prognosis Analysis of Patients with Pancreatic Neuroendocrine Tumors After Surgical Resection and the Application of Enucleation.

Objective: To investigate the prognostic factors of patients with pancreatic neuroendocrine tumor (pNENs) after surgical resection, and to analyze the value of enucleation for pNETs without distant metastasis that are well-differentiated (G1) and have a diameter ≤ 4cm. Methods: : Data from pNET patients undergoing surgical resection between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier analysis and log-rank testing were used for the survival comparisons. Adjusted HRs with 95% CIs were calculated using univariate and multivariate Cox regression models to estimate the prognostic factors. P < .05 was regarded as statistically significant. Results: : This study found that female, cases diagnosed after 2010, and pancreatic body/tail tumors were protective factors for good survival，while histological grade G3, a larger tumor size, distant metastasis, AJCC 8th Stage III-IV and age over 60 were independent prognostic factors for a worse OS/CSS. For the pNETs that were well-differentiated (G1) and had a tumor diameter ≤ 4 cm, the type of surgery was an independent factor for the long-term prognosis of this group. Compared with pancreaticoduodenectomy and total pancreatectomy, patients who were accepted enucleation had better OS/CSS. Conclusion: For pNETs patients undergoing surgical resection, sex, year of diagnosis, tumor location, pathological grade, tumor size, distant metastasis, race, and age were independent prognostic factors associated with the OS/CSS of patients. For pNETs patients with G1 and a tumor diameter less than 4cm, if the tumor is located over 3 mm from the pancreatic duct, enucleation may be a wise choice.