Epidemiology data on 108 MEN 1 patients from the GTE with isolated nonfunctioning tumors of the pancreas.
OBJECTIVE
To analyze the penetrance and clinical course of isolated nonfunctioning tumors of the pancreas (NFTP) in MEN 1 patients, and to propose a strategy for managing them.


BACKGROUND
Pancreaticoduodenal tumors develop in a majority of MEN 1 patients and are a major cause of death. The natural history of NFTP is poorly defined, and no clear-cut guidelines have been widely accepted regarding treatment.


METHODS
Data on 108 patients with isolated NFTP among 579 MEN 1 patients from the French Endocrine Tumor Study Group (GTE) were analyzed. Survival rates were calculated using the Kaplan-Meier method.


RESULTS
The penetrance of NFTP was 34% at age 50, making it the most frequent pancreaticoduodenal tumor in MEN 1 patients. Forty-three patients (40%) underwent surgery, 32 of them curatively. No patient died because of surgery. Average life expectancy for patients with NFTP was shorter than that for MEN 1 patients who did not have pancreaticoduodenal tumors. Thirteen patients died during follow-up, 10 due to NFTP. Tumor size was correlated with the risks of metastasis and death. These risks were low for patients with tumors<or=20 mm.


CONCLUSIONS
NFTP are currently the most common tumors of the pancreaticoduodenal region in patients with MEN 1. Prevention of tumor spread by surgery should be balanced with potential operative mortality and morbidity. We do not recommend routine surgery for NFTP<or=20 mm.
Triponez
Frederic
F
General and Endocrine Surgery, University Hospital, Lille, France. frederic.triponez@hcuge.ch
Dosseh
David
D
Goudet
Pierre
P
Cougard
Patrick
P
Bauters
Catherine
C
Murat
Arnaud
A
Cadiot
Guillaume
G
Niccoli-Sire
Patricia
P
Chayvialle
Jean-Alain
JA
Calender
Alain
A
Proye
Charles A G
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000453:epidemiology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000601:surgery; D012042:Registries; D015996:Survival Rate