title: Neuroendocrine tumours of the pancreas: predictors of survival after surgical treatment.
abstract: OBJECTIVE
  Neuroendocrine tumours of pancreatic and duodenal origin (NETP) are rare and we present a significant experience from a single centre.
  
  
  METHODS
  Data was collected on 44 patients who underwent surgery between 1988 and 2002. Since 1997, data have been recorded prospectively on a dedicated database.
  
  
  RESULTS
  Twenty-four patients had functioning tumours (16 insulinomas, 3 gastrinomas, 2 somatostatinomas, 1 vipoma, 1 glucagonoma and 1 carcinoid tumour). Nine functioning tumours and 13 non-functioning had a malignant phenotype. Twenty pancreaticoduodenectomies, 9 local excisions, 7 distal and 2 total pancreatectomies, 5 bypasses and 1 exploratory laparotomy were performed. Fourteen patients (31.8%) had surgical complications, 1 died peri-operatively (2.3%). The overall actuarial survival for resected cases was 74.4 and 42.5% at 5 and 10 years, respectively. Lymph node invasion and metastases were significant predictors of survival by univariate analysis and only the presence of metastases retained significance on multivariate analysis.
  
  
  CONCLUSIONS
  Surgical resection is the only curative treatment for NETP. Resection can be safely carried out in a specialist centre and is associated with good long-term survival. The presence of metastases was a significant predictive factor for survival in patients with NEPT in this series.
authors.affiliation: The Liver Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
authors.forename: N P
authors.initials: NP
authors.lastname: Jarufe
authors.forename: C
authors.initials: C
authors.lastname: Coldham
authors.forename: T
authors.initials: T
authors.lastname: Orug
authors.forename: A D
authors.initials: AD
authors.lastname: Mayer
authors.forename: D F
authors.initials: DF
authors.lastname: Mirza
authors.forename: J A C
authors.initials: JA
authors.lastname: Buckels
authors.forename: S R
authors.initials: SR
authors.lastname: Bramhall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome