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Published in: World Journal of Surgery 5/2006

01-05-2006

Is Surgery Beneficial for MEN1 Patients with Small (≤2 cm), Nonfunctioning Pancreaticoduodenal Endocrine Tumor? An Analysis of 65 Patients from the GTE

Authors: Frederic Triponez, MD, Pierre Goudet, MD, David Dosseh, MD, Patrick Cougard, MD, Catherine Bauters, MD, Arnaud Murat, MD, Guillaume Cadiot, MD, Patricia Niccoli-Sire, MD, Alain Calender, MD, Charles A. G. Proye, MD, FRCS (Eng), FRCS Ed (Hon)

Published in: World Journal of Surgery | Issue 5/2006

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Abstract

Background

The management of small, nonfunctioning pancreaticoduodenal endocrine tumors (NFPET) in multiple endocrine neoplasia type 1 (MEN1) patients is still controversial. We therefore investigated the effect of surgery on survival and tumor progression in MEN1 patients with NFPET ≤2 cm by analyzing data from the Groupe des Tumeurs Endocrines (GTE) registry.

Materials and Methods

Among 579 MEN1 patients in the registry, 65 had NFPET ≤ 2 cm. Fifteen (23%) underwent pancreatectomy, 9 at least segmental pancreatectomies and 6 biopsies or enucleations (the surgery group), and 50 (77%) were followed conservatively (the no surgery group). Age at MEN1 and NFPET diagnosis was similar in both groups, as was size of the primary tumor. Seven (10.8%) patients had metastases. Five metastases were synchronous, and 2 (one in each group) were metachronous. Tumor size was similar in patients with or without metastasis.

Results

There was no perioperative mortality. The average follow-up time after NFPET diagnosis was 6.7 years in the surgery group and 3.3 years in the no surgery group. Three (4.6%) patients died during follow-up, 2 due to NFPET and 1 due to thymus tumor. The 2 patients who died of NFPET had undergone pancreatic surgery at the time of NFPET diagnosis. The 2 groups did not differ significantly with respect to tumor progression [5/15 (33%) vs 6/38 (16%), P = 0.16]. Overall life expectancy of patients with NFPET ≤2 cm was not different than that of the 229 MEN1 patients in the registry without any pancreaticoduodenal tumor (P = 0.33).

Conclusions

This study suggests that surgery may not be beneficial for MEN1 patients with NFPET ≤2 cm.
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Metadata
Title
Is Surgery Beneficial for MEN1 Patients with Small (≤2 cm), Nonfunctioning Pancreaticoduodenal Endocrine Tumor? An Analysis of 65 Patients from the GTE
Authors
Frederic Triponez, MD
Pierre Goudet, MD
David Dosseh, MD
Patrick Cougard, MD
Catherine Bauters, MD
Arnaud Murat, MD
Guillaume Cadiot, MD
Patricia Niccoli-Sire, MD
Alain Calender, MD
Charles A. G. Proye, MD, FRCS (Eng), FRCS Ed (Hon)
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0354-9

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