Detection of pancreatic neuroendocrine tumors: 23 years of experience

Rev Gastroenterol Mex (Engl Ed). 2019 Jan-Mar;84(1):18-25. doi: 10.1016/j.rgmx.2018.02.015. Epub 2018 May 30.
[Article in English, Spanish]

Abstract

Introduction and aims: Neuroendocrine tumors are of great scientific interest, given that they are difficult to diagnose and treat. Despite being relatively rare (< 1/100,000 individuals, 1-2% of the gastrointestinal neoplasias) and indolent, their potential malignancy must not be forgotten. An increase in the number of diagnosed tumors has been observed in recent years. The aim of the present study was to update a published case series of 19 patients suspected of presenting with pancreatic neuroendocrine tumor with 51 current cases, to study and compare the new results with those of the previous case series, as well as with other recent publications from Spain, the United States, China, and India.

Materials and methods: A retrospective, multicenter case series was conducted on 70 patients (19 cases published in 2011), whose data has been collected over a period of 23 years. The variables analyzed were: age, sex, symptomatology, tumor size, location, metastasis, final diagnosis, and surgery, among others.

Results: Mean patient age was 55 years and 60% of the patients were men. Disease location was the pancreatic head in 28.5% of the patients and the tail in 27.1%, mean tumor size was 3.9cm (0.2-10cm), 71.4% of the patients had non-functioning tumors, 32.8% had metastases (100% to the liver), 74.2% of the patients were operated on, and actuarial survival was 75%.

Conclusions: Differences were observed between the previously published case series and the current results. There was an increase in incidentalomas and non-functioning tumors, but no variation in the overall survival rate. The differences with other case series (age, sex, and tumor location) were dependent on the country where the cases were compiled. The increase in tumors could be related to a higher number of diagnoses made through imaging studies and to the greater sensitivity of the devices employed.

Keywords: Endoscopic ultrasound; Endoscopic ultrasound-guided fine needle aspiration; Pancreatic neuroendocrine tumors; Punción aspiración con aguja fina guiada por ecoendoscopia; Tumores neuroendocrinos pancreáticos; Ultrasonografía endoscópica.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Duodenal Neoplasms / diagnosis
  • Duodenal Neoplasms / diagnostic imaging
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Female
  • Humans
  • Intestinal Neoplasms / diagnosis*
  • Intestinal Neoplasms / diagnostic imaging*
  • Male
  • Mass Screening
  • Middle Aged
  • Neuroendocrine Tumors / diagnosis*
  • Neuroendocrine Tumors / diagnostic imaging*
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / diagnostic imaging*
  • Retrospective Studies
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / diagnostic imaging*
  • Young Adult

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor