title: Predictive factors associated with long-term survival in patients with neuroendocrine tumors of the pancreas.
abstract: BACKGROUND
  Neuroendocrine tumors of the pancreas are rare tumors. We identified predictive factors that are associated with long-term survival (> or=5 years).
  
  
  METHODS
  Fifty patients with a diagnosis of neuroendocrine tumors of the pancreas were retrospectively evaluated. The following factors were evaluated for disease-specific mortality: age, sex, primary tumor location, functional status, type of primary tumor treatment, presence or absence of liver metastases, timing of liver metastases occurrence, and type of liver metastases treatment. Aggressive treatment of the liver metastases included surgery, chemoembolization, or intrahepatic arterial infusion chemotherapy.
  
  
  RESULTS
  Twenty-three patients (47%) had tumor located in the head of the pancreas, and 29 patients (58%) had nonfunctioning tumor. Thirty-nine patients (78%) had liver metastases. The median follow-up for the entire group was 35 months (range,.76-206 months). The median survival for the entire group was 40 months, and the overall 1-, 2-, and 5-year survival rates were 84%, 69%, and 36%, respectively. Factors that had a significant favorable effect on survival included curative resection of the primary tumor, metachronous liver metastases, absence of liver metastases, and aggressive treatment of the liver metastases.
  
  
  CONCLUSIONS
  Definitive surgical resection of the primary tumor, absence of liver metastases, metachronous liver metastases, and aggressive treatment of the liver metastases were predictors of long-term survival in patients with neuroendocrine tumors of the pancreas.
authors.affiliation: Department of Surgical Oncology, Roswell Park Cancer Institute, State University of New York at Buffalo, Buffalo, New York 14263, USA.
authors.forename: Quyen D
authors.initials: QD
authors.lastname: Chu
authors.forename: Hank C
authors.initials: HC
authors.lastname: Hill
authors.forename: Harold O
authors.initials: HO
authors.lastname: Douglass
authors.forename: Deborah
authors.initials: D
authors.lastname: Driscoll
authors.forename: Judy L
authors.initials: JL
authors.lastname: Smith
authors.forename: Hector R
authors.initials: HR
authors.lastname: Nava
authors.forename: John F
authors.initials: JF
authors.lastname: Gibbs
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment