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Pancreatology. 2009;9(5):670-6. doi: 10.1159/000181179. Epub 2009 Aug 14.

A preoperative prognostic score for resected pancreatic and periampullary neuroendocrine tumours.

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  • 1Division of Surgery and Oncology, School of Cancer Studies, University of Liverpool, Liverpool, UK.



To identify potential preoperative prognostic factors in resected pancreatic and periampullary neuroendocrine tumours.


Clinico-pathological data for 54 consecutive patients with pancreatic or periampullary neuroendocrine tumours referred to our institution over a 10-year period were identified from a prospective database.


34 patients underwent pancreatic resection (12 males, 22 females; median age 54 (IQR 44-71) years). There was a single 30-day mortality (3%). Nodal status (log rank, p = 0.652), microscopic resection margin involvement (p = 0.549) and tumour size (p = 0.122) failed to exhibit any prognostic value. Only the presence of malignant tumour characteristics was associated with poorer overall survival (p = 0.008). Analysis of preoperative parameters showed that age >60 years (p = 0.056), platelet-lymphocyte ratio >300 (p = 0.008), alkaline phosphatase levels >125 U/l (p = 0.042) and alanine aminotransferase >35 U/l (p = 0.016) were adverse prognostic factors. A risk stratification score was generated where each adverse preoperative parameter was allocated a score of 1. A cumulative score of < or =1 was defined as low risk, while a score of > or =2 was defined as high risk. Median overall survival in the high-risk group was 10.4 months, while the median survival in the low-risk group was >60 months (p < 0.001).


Significant prognostic information can be gained from routine preoperative biochemistry and haematology results in resected pancreatic and periampullary neuroendocrine tumours. These findings merit further evaluation in a larger patient cohort.

[PubMed - indexed for MEDLINE]
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